Violence against substance-abusing South African sex workers: intersection with culture and HIV risk

Abstract

The Republic of South Africa has become an epicentre of heterosexual HIV transmission among Black women, and the interface between violence against women, substance abuse, and HIV risk is becoming evident. This paper describes the characteristics of Black South African women who engage in sex work in Pretoria and examines their intersecting experiences of high-risk sexual behaviour, substance abuse, and victimization. Ninety-three women were recruited into the study. Field staff collected biological measures of drug use and administered a structured, self-report interview. Findings indicate that young South African women who engage in sex work and use drugs rely on this activity as their main source of income and are supporting other family members. The majority of sample women reported experiencing some victimization at the hand of men, either clients or boyfriends, with many reporting childhood abuse histories; young women also report great fear of future victimization. Findings also suggest that as a result of their decreased likelihood of using protection, women who reported any sexual or physical victimization are at increased risk for HIV and other STIs. Results support the critical need for targeted, comprehensive interventions that address substance abuse, sexual risk, and violence as interrelated phenomena.

Fatores associados à violência contra mulheres profissionais do sexo de dez cidades brasileiras

“…Wechsberg et al 28 noted that South African female sex workers, especially the younger women and those doing drugs, depend on sex work as their main source of income, including support for other family members. These women reported abuse by men -clients, boyfriends, partners, and family -and great fear of future victimization.…”

Condoms in sub-Saharan Africa

“…In most sex work settings, competition for clients is intense, resulting in workers going along with each client's demands for fear of losing the client or earning less. 33,36,47,123,125,[129][130][131] Time and availability of condoms are the third and fourth themes. Sex workers have described their encounters, especially with casual partners, as brief, with minimal conversation or negotiation.…”

Alcohol, cannabis, and methamphetamine use and other risk behaviours among Black and Coloured South African women: A small randomized trial in the Western Cape

“…Lawrence, Wilson, Eldridge, Brasfield & O'Bannon, 2001). However, only a small number of randomized trials have shown that brief, empowerment theory-based, individual interventions can be adapted to reduce HIV risk behaviours among substance-using South African women (Wechsberg, Luseno, & Lam, 2005;Wechsberg et al, 2006). Preliminary data from an ongoing study in Pretoria, South Africa, also suggest that such interventions can address contextual issues, such as experiences with victimization and communication about condom use with partners .…”

“…CT-WHC was adapted from an evidence-based intervention known as the Women's CoOp (Wechsberg, Lam, Zule & Bobashev, 2004;Lyles et al, 2007). This intervention was developed for substance-abusing African-American women in the United States and adapted for Black African women in Pretoria Wechsberg et al, 2005). CT-WHC further adapted the intervention for both Black African and Coloured South African women in the Western Cape of South Africa using both individual and group formats.…”