Sex Worker Target Audience Research Report - Namibia

This 18-page report shares findings of a study to better understand the situation and information needs of sex workers in Namibia. The study, conducted by Desert Soul Health and Development Communications, forms part of formative research by Soul City Institute for Health and Development Communication and its regional partners to help develop Sexual and Reproductive Health and Rights (SRHR) communication materials for sex workers based at selected borders between Malawi, Zambia, Zimbabwe, and Namibia. The research reveals that there is a need for more sex education and information, and that there should be information provided to teach sex workers about HIV prevention.

The report outlines the following findings:

• Reasons for Engaging in Sex work: When asked why they went into the trade, most participants mentioned economic reasons as a key contributing factor, and added that there are no job opportunities for them while, and that they need to care for their children, siblings, and parents. Some participants reported being raped or molested by close relatives and being orphaned at an early age as contributing factors. Research participants also referred several times to the fact that they were introduced to sex work by a friend or a family relative who wanted them to contribute financially to the family upkeep. One male sex worker said that he started by dating some of the sex workers for their money and eventually started recruiting his female clients in cocktail bars. Some of these male sex workers would act as pimps for the female sex workers and would receive monetary compensation from the female sex workers.
• Challenges: The challenges that sex workers encounter are different between male and female sex workers. Female sex workers experience physical and sexual violence more regularly than do their male counterparts. There is also the general sense of physical hardship in the long distances that sex workers have to travel in order to meet their clients, without getting adequate reward for their effort. To this the research participants elaborated that sometimes they are taken by the clients and dropped off on the other side of town or very far from where they normally work. When asked what they would do with regard to the physical violence and sexual coercion they felt that there is not much to do, and that they got used to the various forms of abuse in their work. As a result they don’t do anything about it.
• Reporting to police: Research participants also indicated that they cannot report these incidences to the police, since they do not know the real name of their clients, or the vehicle registration number, or where the clients can be found. In addition to abuse from clients, some of the research participants mentioned that even the police officers abuse them and force them to go home if they are found on the street. This concern is raised by female participants who relate incidences of police men who arrest them, and negotiate for sexual favours while on the way to the police station.
• HIV Concerns: Others are concerned about getting HIV from their clients, more so with clients who insist on unprotected sexual intercourse with the promise of paying more. Other concerns are sexual preferences of clients especially with regards to oral or anal sex. Some sex workers expressed a discomfort with this but the clients’ willingness to pay more compels the sex workers to comply with these demands. In the case of male sex workers, some of their female clients feel as if the male sex worker belongs to them and would also insist on sex without condoms especially when paying more.
• Risk Perception: In finding out what risks were involved in their work, almost all sex workers, male and female, said that insistence of clients on sex without a condom was a risk. This risk was clearly linked to the risk of being infected with HIV by all. Other risks relate to physical violence by clients who don’t want to pay after they have made use of their service. Some of the violence seemed to relate to a complete disregard of the sex workers right to dignity and borders on bullying. All participants reiterate that sex work can lead to your death, since you can possibly be beaten to death or pushed out of a moving car.
• Health Services: It was found that some sex workers take their health very seriously and are able to identify STI’s from symptoms such as a yellow discharge, pain when urinating, and itching genitals. Those that have been tested for HIV and are positive, are on ARVs and visiting health facilities regularly for services such as pap smears. Okuryanga Clinic, Katutura Hospital, and New Start Centre were especially mentioned as places visited by sex workers when they experience sexual health problems. On the other hand, some respondents from the mixed group expressed the sentiment that they don’t access health facilities, but rather opt to discuss their sexual health issues with their friends. They refrain from telling health professionals, largely due to the perceived stigma around sex work. Some don’t go for blood testing, because they are afraid to know their status.
• Accessing Services: When asked about the challenges they experience in accessing sexual health services, two participants mentioned they had no challenges in accessing SRHR services. In some of the locations where sex workers reside, there are no health services and as a result they walk long distances to access these services. The non-availability of condoms was prominently mentioned as a major challenge for most sex workers. The unavailability of condoms makes it difficult for sex workers to insist on condom use especially with clients who offer high payment for unsafe sex. Besides the fact that services are far from where most sex workers live and that condoms are not readily available, there seems at be a preference for exclusive service that provides condoms only for sex workers as opposed to the public health facilities accessed by all. Participants also mentioned that they can sometimes not afford the transport fees, as well as the hospital fees that they need to pay when accessing health services.
• Required Services: Research participants mentioned that there are various types of SRHR services needed by sex workers. They added that they need health care facilities exclusively for sex workers, since there are a lot of people in the public health centres which means that accessing health serves takes a lot of their time. Participants noted that there should be clinics that will provide all services for free, including the distribution of condoms, medicine for the sick, and even HIV testing services. Some of the female sex workers indicated that there should be shelters, because some of them still don’t have their own places. Male research respondents noted that they also need more male condoms in the bars because they are easy to use, and that there should be stronger condoms because they feel that currently the condoms are not strong enough.
• Solutions to Violence: When asked about solutions to reduce violence against them, participants mentioned that they need protection from the government by making sure that the police take action against people that are harming them, instead of chasing them away when they need help. They also agree that they must start reporting abuse to the police and that the police should also understand that they don't have jobs, and have to resort to sex work for a living. Participants reiterate that the police should attend to their problems when they are reported. The younger participants strongly feel that the government must give free education so that they don’t find it difficult to pay school fees. This especially relates to the sex workers who have been orphaned at a young age.
• HIV Prevention: The research revealed that HIV and AIDS are very serious problems because most sex workers are not serious with prevention measures to avoid contracting HIV and other STI’s, while some of them just care about the money they are getting and not their health. Both male and female participants agree that they don’t know much about the disease (HIV), and that there is a need to know one’s status so that you can get the necessary treatment in time. Research participants indicate varying degrees of utilising HIV testing services. Some have been tested already, and know that they are HIV positive. They also stress that they should get tested for HIV every three months.

The research reveals that there is a need for more sex education and information, and that there should be information provided to teach sex workers about HIV prevention. Research participants strongly feel that information must be given to the people because even young kids want to get involved in sex work. Participants agree that there should be awareness campaigns that will help educate sex workers of things they should do if they are facing abuse. Both male and female sex workers mention that they want to hear everything there is to know about HIV and also of health problems. All agree that information should be put in booklets, pamphlets, newspapers, radio, and TV.

To obtain a copy of the report, please email Desert Soul at the contacts below.