Physical and Sexual Violence Affecting Female Sex Workers in Abidjan, Côte d'Ivoire: Prevalence and the Relationship between Violence, the Work Environment, HIV and Access to Health Services

April 2017 - Structural Prevention

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Lyons, C., Ketende, S., Drame, F., and Grosso, A., et al. Journal of Acquired Immune Deficiency Syndromes (February 2017), e-publication ahead of print, doi:10.1097/QAI.0000000000001310.

This study estimated the prevalence of violence (physical and sexual) among female sex workers (FSWs) in Côte d'Ivoire, where sex work is legal but soliciting is criminalized, and examined structural risks for HIV in this context. The authors used respondent-driven sampling to recruit 466 FSWs aged over 18 years in Abidjan and administered HIV testing and a socio-behavioral questionnaire that included information on work-related risks, payment arrangements, police practices, and health service indicators. One-quarter (24.1%) of participants reported that police refused to protect them because of their work; 31.2 percent reported harassment or intimidation; both were significantly associated with physical and sexual violence. One-fifth of the FSWs reported being blackmailed, which was associated with physical and sexual violence, and the majority (80.5%) had been offered more money for condomless sex, which was associated with sexual violence. HIV prevalence among participants was 11 percent, but 25 percent overall said that they avoided health services because of their profession. These findings, the authors said, indicate the need for structural interventions and policy reforms to improve work environments and to address police harassment, stigma, and rights violations to reduce violence and improve access to HIV interventions for FSWs in Côte d'Ivoire.

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