The social dynamics of selling sex in Mombasa, Kenya: a qualitative study contextualizing high risk sexual behaviour

Abstract

Female sex workers (FSWs) in sub-Saharan Africa have one of the highest HIV seroprevelance rates of any population. Effective safe sex interventions are urgently needed to stop the transmission of HIV during commercial sex. Despite widespread education, counselling, and condom distribution interventions among FSWs, unprotected sexual intercourse remains a large behavioural challenge. Research on this topic has been limited primarily to establishing the frequency of high risk sexual behaviour without a comprehensive analysis of the social environment creating these factors, especially gender inequality. Through qualitative indepth interviews and focus group discussions with FSWs, this article contextualizes the selling of sex in one large urban city of Kenya. The results of this study indicate that FSWs will never be able to enforce safe sex among male clients in such settings without structural interventions that address gendered socioeconomic power imbalances. Policy  implications based on these findings include re-evaluating laws against the selling of sex and prioritizing female education and economic opportunities. (Afr J Reprod Health 2013; 17[2]: 141-149).

Keywords: female sex work, sub-Saharan Africa, gender inequality, Kenya, sexual behaviour, HIV/AIDS