Skip to main content
Top
Published in: BMC Women's Health 1/2011

Open Access 01-12-2011 | Research article

"I do what I have to do to survive": An investigation into the perceptions, experiences and economic considerations of women engaged in sex work in Northern Namibia

Authors: Alanna Fitzgerald-Husek, Alexandra LC Martiniuk, Reece Hinchcliff, Christine E Aochamus, Richard B Lee

Published in: BMC Women's Health | Issue 1/2011

Login to get access

Abstract

Background

There is little published research investigating sex work in Namibia, particularly in rural areas. Therefore, the aim of this paper was to determine the views of women engaged in sex work in the Oshakati area of Namibia concerning the main factors influencing their use, or non-use, of male condoms during transactional sexual exchanges.

Methods

Qualitative interviews were used to better understand the perceptions, experiences and economic considerations of female sex workers in Namibia who were involved in a Behavior Change Communication Program encouraging safer sex practices among high-risk populations in 2006 and 2007.

Results

While the Behavior Change Communication Program has made significant strides in educating and empowering young women to negotiate more consistent condom use with sexual partners, the gendered economic inequalities and power imbalances within rural and semi-urban Namibian society that favor men hinder further advancement towards positive behavioral change for HIV prevention and also hinder the development of the loving relationships sought by some sex workers.

Conclusion

This study found that sex workers and transactional sex encounters are heterogeneous entities dependent upon the characteristics of the man (known, stranger, wealthy, attractive to the woman) and the woman (in financial need, desiring love). These features all influence condom use. The 3 E's 'education, empowerment and economic independence' are critical factors needed to encourage and facilitate consistent condom use to prevent HIV transmission. Without financial independence and occupational alternatives building on their health education and empowerment, women who engage in sex work-and transactional sex more generally-will remain largely marginalized from Namibian society, and will continue engaging in risky sexual practices that facilitate HIV acquisition and transmission throughout the community.
Literature
1.
go back to reference Luke N: Age and economic asymmetries in the sexual relationships of adolescent girls in sub-Saharan Africa. Studies in Family Planning. 2003, 34 (2): 67-86. 10.1111/j.1728-4465.2003.00067.x.CrossRefPubMed Luke N: Age and economic asymmetries in the sexual relationships of adolescent girls in sub-Saharan Africa. Studies in Family Planning. 2003, 34 (2): 67-86. 10.1111/j.1728-4465.2003.00067.x.CrossRefPubMed
2.
go back to reference Campbell C: 'Letting them die': Why HIV/AIDS prevention programmes fail. 2003, Bloomington, IN: Indiana University Press Campbell C: 'Letting them die': Why HIV/AIDS prevention programmes fail. 2003, Bloomington, IN: Indiana University Press
3.
go back to reference Iipinge S: The relationship between gender roles and HIV infection in Namibia. Government leaders in Namibia responding to the HIV/AIDS epidemic: 2003; Safari Court Conference Centre. 2003, University of Namibia Press, 130-151. Iipinge S: The relationship between gender roles and HIV infection in Namibia. Government leaders in Namibia responding to the HIV/AIDS epidemic: 2003; Safari Court Conference Centre. 2003, University of Namibia Press, 130-151.
4.
go back to reference UNAIDS: Report on the global HIV/AIDS epidemic 2008: executive summary. 2008, Geneva: Joint United Nations Programme on HIV/AIDS (UNAIDS) UNAIDS: Report on the global HIV/AIDS epidemic 2008: executive summary. 2008, Geneva: Joint United Nations Programme on HIV/AIDS (UNAIDS)
5.
go back to reference UNGASS: United Nations General Assembly Special Session Country Report: Reporting Period 2008-2009. 2008, Windhoek, Namibia: Republic of Namibia Ministry of Health and Social Services UNGASS: United Nations General Assembly Special Session Country Report: Reporting Period 2008-2009. 2008, Windhoek, Namibia: Republic of Namibia Ministry of Health and Social Services
6.
go back to reference Cornish F, Campbell C: The social conditions for successful peer education: a comparison of two HIV prevention programs by sex workers in India and South Africa. American Journal of Community Psychology. 2009, 44: 123-135. 10.1007/s10464-009-9254-8.CrossRefPubMed Cornish F, Campbell C: The social conditions for successful peer education: a comparison of two HIV prevention programs by sex workers in India and South Africa. American Journal of Community Psychology. 2009, 44: 123-135. 10.1007/s10464-009-9254-8.CrossRefPubMed
7.
go back to reference Thomas F: Global rights, local realities: negotiating gender equality and sexual rights in the Caprivi Region, Namibia. Cult Health Sex. 2007, 9 (6): 599-614. 10.1080/13691050701526263.CrossRefPubMed Thomas F: Global rights, local realities: negotiating gender equality and sexual rights in the Caprivi Region, Namibia. Cult Health Sex. 2007, 9 (6): 599-614. 10.1080/13691050701526263.CrossRefPubMed
8.
go back to reference OSHD: Republic of Namibia: country gender profile. 2006, Tunis-Belvedère, Tunisia: African Development Bank African Development Fund OSHD: Republic of Namibia: country gender profile. 2006, Tunis-Belvedère, Tunisia: African Development Bank African Development Fund
10.
go back to reference Gysels M, Pool R, Nnalusiba B: Women who sell sex in a Ugandan trading town: life histories, survival strategies and risk. Social Science & Medicine. 2002, 54: 179-192. 10.1016/S0277-9536(01)00027-2.CrossRef Gysels M, Pool R, Nnalusiba B: Women who sell sex in a Ugandan trading town: life histories, survival strategies and risk. Social Science & Medicine. 2002, 54: 179-192. 10.1016/S0277-9536(01)00027-2.CrossRef
11.
go back to reference Hunter M: The materiality of everyday sex: Thinking beyond 'prostitution'. African Studies. 2002, 61 (1): 99-120. 10.1080/00020180220140091.CrossRef Hunter M: The materiality of everyday sex: Thinking beyond 'prostitution'. African Studies. 2002, 61 (1): 99-120. 10.1080/00020180220140091.CrossRef
12.
go back to reference Raingruber B, Uwazie E, Bowie S: Women's voices: attitudes and behaviors of female Ghanaian sex workers regarding HIV prevention and AIDS-related stigma. Issues in Mental Health Nursing. 2010, 31: 514-519. 10.3109/01612841003646999.CrossRefPubMed Raingruber B, Uwazie E, Bowie S: Women's voices: attitudes and behaviors of female Ghanaian sex workers regarding HIV prevention and AIDS-related stigma. Issues in Mental Health Nursing. 2010, 31: 514-519. 10.3109/01612841003646999.CrossRefPubMed
13.
go back to reference Onyeneho NG: HIV/AIDS risk factors and economic empowerment needs of female sex workers in Enugu Urban, Nigeria. Tanzania Journal of Health Research. 2009, 11 (3): 126-135.CrossRefPubMed Onyeneho NG: HIV/AIDS risk factors and economic empowerment needs of female sex workers in Enugu Urban, Nigeria. Tanzania Journal of Health Research. 2009, 11 (3): 126-135.CrossRefPubMed
14.
go back to reference Lafort Y, Geelhoed D, Cumba L, Lázaro CDDM, Delva W, Luchters S, Temmerman M: Reproductive health services for populations at high risk of HIV: performance of a night clinic in Tete province, Mozambique. BMC Health Services Research. 2010, 10: 144-152. 10.1186/1472-6963-10-144.CrossRefPubMedPubMedCentral Lafort Y, Geelhoed D, Cumba L, Lázaro CDDM, Delva W, Luchters S, Temmerman M: Reproductive health services for populations at high risk of HIV: performance of a night clinic in Tete province, Mozambique. BMC Health Services Research. 2010, 10: 144-152. 10.1186/1472-6963-10-144.CrossRefPubMedPubMedCentral
15.
go back to reference Foss AM, Hossain M, Vickerman PT, Watts CH: A systematic review of published evidence on intervention impact on condom use in sub-Saharan Africa and Asia. Sexually Transmitted Infections. 2007, 83: 510-516. 10.1136/sti.2007.027144.CrossRefPubMedPubMedCentral Foss AM, Hossain M, Vickerman PT, Watts CH: A systematic review of published evidence on intervention impact on condom use in sub-Saharan Africa and Asia. Sexually Transmitted Infections. 2007, 83: 510-516. 10.1136/sti.2007.027144.CrossRefPubMedPubMedCentral
16.
go back to reference Shahmanesh M, Patel V, Mabey D, Cowan F: Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sex workers in resource poor setting: a systematic review. Tropical Medicine and International Health. 2008, 13 (5): 659-679. 10.1111/j.1365-3156.2008.02040.x.CrossRefPubMed Shahmanesh M, Patel V, Mabey D, Cowan F: Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sex workers in resource poor setting: a systematic review. Tropical Medicine and International Health. 2008, 13 (5): 659-679. 10.1111/j.1365-3156.2008.02040.x.CrossRefPubMed
17.
go back to reference LeBeau D: The economics of sex work and its implications for sex workers' HIV risk-taking in Namibia. Unravelling taboos: gender and sexuality in Namibia. Edited by: Hubbard D, LaFont S. 2007, Windhoek, Namibia: Legal Assistance Centre, 255-274. LeBeau D: The economics of sex work and its implications for sex workers' HIV risk-taking in Namibia. Unravelling taboos: gender and sexuality in Namibia. Edited by: Hubbard D, LaFont S. 2007, Windhoek, Namibia: Legal Assistance Centre, 255-274.
18.
go back to reference Hjorth C: Prostitution, HIV/AIDS, and human rights: a case study of sex workers in the township of Katatura, Namibia. 2005, Göteborg University Hjorth C: Prostitution, HIV/AIDS, and human rights: a case study of sex workers in the township of Katatura, Namibia. 2005, Göteborg University
20.
go back to reference Unknown: Feminization of AIDS. New York Times. 2004 Unknown: Feminization of AIDS. New York Times. 2004
21.
go back to reference Martiniuk ALC, O'Connor KS, King WD: A cluster randomized trial of a sex education programme in Belize, Central America. International Journal of Epidemiology. 2003, 32 (1): 131-136. 10.1093/ije/dyg014.CrossRefPubMed Martiniuk ALC, O'Connor KS, King WD: A cluster randomized trial of a sex education programme in Belize, Central America. International Journal of Epidemiology. 2003, 32 (1): 131-136. 10.1093/ije/dyg014.CrossRefPubMed
22.
go back to reference Albarracín D, Johnson BT, Fishbein M, Muellerleile PA: Theories of reasoned action and planned behaviour as models of condom use: A meta-analysis. Psychological Bulletin. 2001, 127 (1): 142-161.CrossRefPubMedPubMedCentral Albarracín D, Johnson BT, Fishbein M, Muellerleile PA: Theories of reasoned action and planned behaviour as models of condom use: A meta-analysis. Psychological Bulletin. 2001, 127 (1): 142-161.CrossRefPubMedPubMedCentral
23.
go back to reference Allen CF, Simon Y, Edwards J, Simeon DT: Factors associated with condom use: economic security and positive prevention among people living with HIV/AIDS in the Caribbean. AIDS Care. 2010, 22 (11): 1386-94. 10.1080/09540121003720978.CrossRefPubMed Allen CF, Simon Y, Edwards J, Simeon DT: Factors associated with condom use: economic security and positive prevention among people living with HIV/AIDS in the Caribbean. AIDS Care. 2010, 22 (11): 1386-94. 10.1080/09540121003720978.CrossRefPubMed
24.
go back to reference Dunkle KL, Wingood GM, Camp CM, DiClemente RJ: Economically motivated relationships and transactional sex among unmarried African American and white women: results from a US national telephone survey. Public Health Rep. 2010, 125 (Suppl 4): 9-100. Dunkle KL, Wingood GM, Camp CM, DiClemente RJ: Economically motivated relationships and transactional sex among unmarried African American and white women: results from a US national telephone survey. Public Health Rep. 2010, 125 (Suppl 4): 9-100.
25.
go back to reference Johnston CL, Callon C, Li K, Wood E, Kerr T: Offer of financial incentives for unprotected sex in the context of sex work. Drug Alcohol Rev. 2010, 29 (2): 144-9.CrossRefPubMedPubMedCentral Johnston CL, Callon C, Li K, Wood E, Kerr T: Offer of financial incentives for unprotected sex in the context of sex work. Drug Alcohol Rev. 2010, 29 (2): 144-9.CrossRefPubMedPubMedCentral
26.
go back to reference Caffrey P, Weiss E, Wood L, Connor E, Orza L, Trasi R: Engaging parliamentarians as advocates for women's health: findings from Kenya and Namibia. Global Public Health. 2009, 4 (3): 271-283. 10.1080/17441690902769651.CrossRefPubMed Caffrey P, Weiss E, Wood L, Connor E, Orza L, Trasi R: Engaging parliamentarians as advocates for women's health: findings from Kenya and Namibia. Global Public Health. 2009, 4 (3): 271-283. 10.1080/17441690902769651.CrossRefPubMed
27.
go back to reference Sangani P, Rutherford G, Wilkinson D: Population-based interventions for reducing sexually transmitted infections, including HIV infection. Cochrane Database Syst Rev. 2004, CD001220-2 Sangani P, Rutherford G, Wilkinson D: Population-based interventions for reducing sexually transmitted infections, including HIV infection. Cochrane Database Syst Rev. 2004, CD001220-2
28.
go back to reference Creese A, Floyd K, Alban A, Guiness L: Cost effectiveness of HIV/AIDS interventions in Africa: a systematic review of the evidence. Lancet. 2002, 359 (9318): 1635-43. 10.1016/S0140-6736(02)08595-1.CrossRefPubMed Creese A, Floyd K, Alban A, Guiness L: Cost effectiveness of HIV/AIDS interventions in Africa: a systematic review of the evidence. Lancet. 2002, 359 (9318): 1635-43. 10.1016/S0140-6736(02)08595-1.CrossRefPubMed
29.
go back to reference Swendeman D, Basu I, Das S, Jana S, Rotheram-Borus MJ: Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases. Soc Sci Med. 2009, 69 (8): 1157-66. 10.1016/j.socscimed.2009.07.035.CrossRefPubMedPubMedCentral Swendeman D, Basu I, Das S, Jana S, Rotheram-Borus MJ: Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases. Soc Sci Med. 2009, 69 (8): 1157-66. 10.1016/j.socscimed.2009.07.035.CrossRefPubMedPubMedCentral
Metadata
Title
"I do what I have to do to survive": An investigation into the perceptions, experiences and economic considerations of women engaged in sex work in Northern Namibia
Authors
Alanna Fitzgerald-Husek
Alexandra LC Martiniuk
Reece Hinchcliff
Christine E Aochamus
Richard B Lee
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2011
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/1472-6874-11-35

Other articles of this Issue 1/2011

BMC Women's Health 1/2011 Go to the issue