How Does Mobility Impact the Health of Female Sex Workers?

Introduction

Around the world, many women rely on sex work to make a living for themselves and their families. Sex workers face large amounts of stigma and criminalization, which make enacting safety measures to prevent violence difficult. Beyond the increased risk of sexual violence, sex workers face a much higher risk of HIV, sexually transmitted infections, and bloodborne infections such as hepatitis. According to the World Health Organization, female sex workers are 30 times more likely to be living with HIV than other women of reproductive age.

Research Focus

SIS professor Maria De Jesus focused her recent research article on female sex workers in the Dominican Republic and Tanzania living with HIV. Her research examines how mobility impacts the sex worker’s ability to access HIV care and highlights the health sacrifices these women often make to sustain their livelihood.

Research Questions

1. What made you pursue this specific type of research? How did you decide to focus your research on these two locations?
• This research draws on a larger National Institutes of Health (NIH) longitudinal study that followed 400 female sex workers (FSWs) living with HIV in Santo Domingo, Dominican Republic, and Iringa, Tanzania, to examine the social and structural determinants of the women’s HIV outcomes.
• The Dominican Republic and Tanzania were chosen as locations due to their high prevalence of HIV among sex workers and the unique mobility patterns observed in these settings.
2. What methodology did you utilize for this research?
• This longitudinal mixed methods research study utilized surveys and in-depth interviews conducted in Spanish (Dominican Republic) or Swahili (Tanzania).
• The inclusion criteria included women at least 18 years of age with a confirmed HIV-positive diagnosis who reported exchanging sex for money in the last month prior to their enrollment in the study.
3. You identified three ‘mobility paradoxes’ in your research. Briefly, can you explain what a mobility paradox is and what you found?
• “Mobility paradoxes” refer to the fact that sex work mobility does not simply create disruptors in the lives, livelihoods, and HIV care and treatment experiences of Dominican and Tanzanian FSWs living with HIV, but also offers them important tangible and intangible benefits.
• These paradoxes include both negative experiences, such as violence and exploitation, as well as positive experiences, such as autonomy and economic independence.
4. Sex work is often stigmatized in many parts of the world, and there are few studies conducted on female sex workers. Why did you choose to focus on this population, and why is it important to include sex workers in research?
• It is important to focus on this population and include sex workers in research to shed light on their experiences and improve our understanding of sex work mobility.
• By including sex workers in research, we can challenge negative stereotypes and develop interventions that meet their specific needs.
5. Part of this research also focuses on the health aspects of the subjects’ lives and how mobility affects their HIV-related care. What were the key takeaways, health-wise, from your research?
• The research findings showed that while mobility can disrupt HIV-related care, the women found creative ways to reduce interruptions, such as scheduling appointments around their travel plans and ensuring they had enough medication for the duration of their trips.
• The study highlights the need for strengths-based health interventions that leverage the resiliencies and capabilities of mobile FSWs living with HIV.