Substance Use and Experience of Violence Among Young Women Engaged in Casual, Transactional, and Formal Sex Work in Mombasa, Kenya

Cheuk, Eve

Wednesday, September 21, 2016

Galleria Exhibit Hall

Eve Cheuk, PhD¹, Sharmistha Mishra, MD, FRCP(C), MSc, PhD², Peter Gichangi, MD³, James Blanchard, MD, MPH, PhD¹, Sevgi Aral, PhD⁴, Helgar Musyoki, BSc⁵, Parinita Bhattacharjee, BA, MSW⁶, Shajy Isac, PhD⁷, Elisa Mountain, MSc⁸, Michael Pickles, PhD⁸, Marie-Claude Boily, PhD⁸, Daria Pavlova, PhD⁹, Olga Balakireva, PhD⁹ and Marissa Becker, MD, FRCP(C), MSc¹, 1Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada, 2St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada, 3International Centre for Reproductive Health Kenya, International Centre for Reproductive Health Kenya, Mombasa, Kenya, 4Division of STD Prevention, CDC, Atlanta, GA, 5National AIDS and STI Control Programme, National AIDS and STI Control Programme, Nairobi, Kenya, 6University of Manitoba, Nairobi, Kenya, 7Karnataka Health Promotion Trust, Bangalore, India, 8Department of Infectious Diseases Epidemiology, School of Public Health, Imperial College London, London, United Kingdom, 9Ukrainian Institute for Social Research after Olexander Yaremenko, Ukrainian Institute for Social Research after Olexander Yaremenko, Kiev, Ukraine

Background: Structural vulnerabilities are important facilitators of HIV infection among women. The Transitions study examines young women’s HIV risk and the context of HIV transmission as they progress through their sexual life course from first sex and casual sex to transactional and formal sex work. This presentation focuses on substance use and experience of violence among young Kenyan women who engaged in casual sex (CS), transactional sex (TS) and formal sex work (SW).

Methods: Young women aged 14-24 years in Mombasa, Kenya were sampled “proportional-to-population-size” from hotspots (where female sex workers congregated to seek sex partners) for a cross-sectional survey which solicited information about their sexual and other risk behaviours. Substance use and experience of violence among women who engaged in CS, TS and SW were analyzed using descriptive statistics.

Results: 714, 177 and 408 women who engaged in CS, TS and SW, respectively, participated in the study. While 80.4%, 50.2% and 20.4% women respectively have never had alcoholic beverages, 0.1%, 3.4% and 16.7% consumed alcohol everyday in the last month (p=0.00). Injection drug use was highest among female sex workers (0.1% CS, 0.0% TS, 1.5% SW; p=0.01); they also more commonly experienced physical violence by a sex partner (10.1% CS, 18.39% TS, 28.2% SW; p=0.00). Report of being forced by their first sex partner to have sex while not willing was marked across all groups (13.6% CS, 28.9% TS, 29.6% SW; p=0.00).

Conclusions: Although variability exists, young women who engage in casual and transactional sex are exposed to similar types of structural facilitators of HIV infection compared to female sex workers. To be effective and relevant, HIV prevention programs that are targeted to female sex workers only need to consider expanding their scope of service to those who engage in transactional sex and other forms of high-risk sex.

WP 11 Substance Use and Experience of Violence Among Young Women Engaged in Casual, Transactional, and Formal Sex Work in Mombasa, Kenya