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Placement: Save Lives Ethiopia, Addis Ababa, Ethiopia
Project Title: A Social, Economic, and Physical Needs Assessment
of Commercial Sex Workers in Saris Kuchera Sefer, Ethiopia
Abstract:
Commercial sex workers are a frequently studied
population because of factors such as their social marginalization
and susceptibility to health risks. Despite the growing body of
information regarding commercial sex workers, the success of intervention
attempts in Ethiopia continues to struggle. One perceived reason
for this struggle is the disconnect between the aims and desires
of the researchers/program coordinators, and the realities of the
lives of commercial sex workers. There have been very few research
investigations that focus on the needs of sex workers as perceived
by the sex workers themselves. Instead, the issues surrounding sex
work and perceived avenues to affect change in the lives of sex
workers have primarily been identified by outsiders whose perceptions
of sex work communities were based on research reflecting their
own preconceived notions.
In order to investigate what one community of commercial
sex workers perceived their greatest needs to be, this assessment
was designed and carried out in collaboration with Duke University
and Save Lives Ethiopia, a local NGO in Addis Ababa. The fieldwork
was conducted between November 2006 and March 2007, with the basic
objectives being to determine why the women became involved in sex
work, to assess their knowledge of AIDS and the prevalence of preventative
measures against AIDS, and to determine what they perceived as their
greatest social, economic, and physical needs.
The assessment included both quantitative and qualitative
aspects. The main method of data collection was a 74-question interview,
which consisted of 69 closed quantitative questions and 5 open-ended
qualitative questions. Forty commercial sex workers were involved
as participants in the interviews. Following the completion of the
interviews, two qualitative focus group discussions of six participants
each were conducted. Finally, the results of the interviews and
focus group discussions were individually presented back to eight
participants and their feedback on this data was qualitatively recorded.
The qualitative aspect of the research was designed to expand upon
the major issues identified in the quantitative study and to fill
in gaps in information that the quantitative portion did not necessarily
attend to. Moreover, it intended to provide the respondents an opportunity
to express themselves in an area uninhibited by the constraints
of quantitative questions.
All of the research participants were self-identified
female commercial sex workers living and working in the Kuchera
Sefer neighborhood of Saris in southern Addis Ababa. The research
was limited to women whose sex work, from the meeting of their customers
to the sexual act itself, transpires solely in front of and within
their homes. The majority (70%) of the respondents were between
18 and 23 years old. None of the sex workers were currently married,
but about one-third had children and slightly more were supporting
persons other than themselves. The average grade level completed
was 3.95 and none of the participants were currently attending school.
The median monthly income earned by the women was 560 ETB ($62.92
USD), which they obtained solely from sex work. Amhara (52.5%) and
Oromo (40%) were the predominant ethnicities of the respondents,
and an overwhelming 90% of the women reported to be Ethiopian Orthodox
by religion. Almost three-fourths of the sex workers had been born
outside of Addis Ababa and moved to the city at some point during
their lives.
In brief, the assessment findings are as follows:
• All of the participants were aware of AIDS.
Nearly all could identify at least one means of HIV prevention,
but few could identify three.
• 80% of the sex workers felt they were at little or no risk
of having been exposed to HIV, and the most cited reason was consistent
condom use.
• 100% of participants had access to condoms, with door-to-door
vendors being the most commonly identified source.
• Condoms were used almost universally with customers. However,
a number of the sex workers were having unprotected sex with boyfriends
or trusted partners
• Less than half of the respondents had ever received education
on correct condom use.
• The most frequent source of information and behavioral change
with regards to HIV was the radio. All of the women started using
condoms after hearing about AIDS, but adopted few other behavioral
changes.
• The median age at first sexual intercourse was 15 years
and the most common reason cited for first sexual encounter was
love.
• More than a third of the commercial sex workers had been
raped, and the majority experienced the rape before they became
sex workers
• Sexual violence occurred fairly regularly and was a concern
of many of the respondents.
• Personal knowledge of HIV status was reported to be of high
importance, but only 32.5% of participants had been tested within
the past year. Rationale for lack of testing included low risk perception
and fear of results.
• Women joined sex work most often for survival money and
because of peer pressure. The majority were introduced to sex work
through friends who were already working as commercial sex workers.
• Nearly half of the women used “chat” regularly
and around 30% consumed alcohol regularly. None of the participants
used other drugs regularly.
• The median monthly income was 560 ETB. 40 % of the sex workers
said their income was sufficient for their living needs, whereas
60% said it was not.
• Perception of available health care was positive, with 87.5%
of respondents saying that their available health resources were
adequate.
• Most sex workers did not face discrimination form their
immediate community, but were affected by the negative perception
of sex workers in larger society
Results of the needs assessment are presented and
discussed in this report. The study has identified several issues
and appropriate recommendations are provided based on the relevant
findings of the study.
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