Policing the Epidemic: High Burden of Workplace Violence among Female Sex Workers in Conflict-Affected Northern Uganda

Sex workers in sub-Saharan Africa experience a high burden of HIV with a paucity of data on violence and links to HIV risk among sex workers, and even less within conflict-affected environments. Data are from a cross-sectional survey of female sex workers in Gulu, northern Uganda (n = 400). Logistic regression was used to determine the specific association between policing and recent physical/sexual violence from clients. 

A total of 196 (49.0%) sex workers experienced physical/sexual violence by a client. From those who experienced client violence the most common forms included physical assault (58.7%), rape (38.3%), and gang rape (15.8%) Police harassment was very common, a total of 149 (37.3%) reported rushing negotiations with clients because of police presence, a practice that was significantly associated with increased odds of client violence (adjusted odds ratio: 1.61, 95% confidence intervals: 1.03-2.52). Inconsistent condom use with clients, servicing clients in a bar, and working for a manager/pimp were also independently associated with recent client violence. 

Structural and community-led responses, including decriminalisation, and engagement with police and policy stakeholders, remain critical to addressing violence, both a human rights and public health imperative.

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By: Muldoon KA1,2, Akello M3, Muzaaya G3, Simo A2, Shoveller J1, Shannon K1,2,4.

• 1 School of Population and Public Health , University of British Columbia , Vancouver , Canada.
• 2 British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , Canada.
• 3 The AIDS Support Organization , Gulu , Uganda.
• 4 Department of Medicine , University of British Columbia, St. Paul's Hospital , Vancouver , Canada.  

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