Multiple indicators of violence against female sex workers in Ghana: analysis of the prevalence and the associated factors

Abstract

Background: Violence against female sex workers (FSWs) is a widespread phenomenon primarily because of the pervasive worldview that sex work is a contravention of morality. Violence against FSWs deters them from accessing services and heightens their risk of STIs including HIV infection. Consequently, it is expedient to understand the prevalence and the underlying factors that influence the multiple indicators of violence against FSWs to inform the design and implementation of effective remedial interventions.Objective: This study sought to assess the prevalence and associated factors of physical and sexual violence against FSWs in Ghana.Method: The study used secondary data from the 2015 Integrated Bio-Behavioural Surveillance Survey (IBBSS) among FSWs and their non-paying partners conducted by Ghana AIDS Commission (GAC). Bivariate, and multiple logistic regression analyses were done to establish factors associated with physical and sexual violence against FSWs. Statistical significance was set at a p-value<0.05.Results: The study established the prevalence of physical and sexual violence as 10.1% and 24.8% respectively. Physical violence was perpetrated mainly by first-time paying clients (50.6%) and regular paying clients (31.0%). A similar trend was reported for sexual violence. As established by the study, the predictors of physical violence are type of FSW (p-value<0.01), current age of FSW (p-value=0.02), (geographical) region of residence (p-value<0.01), whether FSW had ever used drugs in the past one year (<0.01) and whether FSW had ever used alcohol before sex in the past six months preceding the survey (p-value<0.01). Sexual violence on the other hand was predicted by current age of FSW (p-value=0.02), marital status (p-value<0.01), number of living children (p-value=0.04), where FSWs take clients for sex (p-value <0.01), (geographical) region of residence (p-value<0.01), history of drug use (p-value <0.01), and history of alcohol use (p-value<0.01). Both physical and sexual violence had negative consequences on consistency of condom use and condom failure among FSWs.Conclusion: Physical and sexual violence against FSWs is pervasive in Ghana and it is influenced by many factors. There is the need for tailored interventions to address the menace in order to enhance FSWs’ ability to access health care services and to use condoms consistently.