Abstract
BackgroundThere is little published research investigating sex work in Namibia, particularly in rural areas. Therefore, the aim of this paper was to determine the views of women engaged in sex work in the Oshakati area of Namibia concerning the main factors influencing their use, or non-use, of male condoms during transactional sexual exchanges.MethodsQualitative interviews were used to better understand the perceptions, experiences and economic considerations of female sex workers in Namibia who were involved in a Behavior Change Communication Program encouraging safer sex practices among high-risk populations in 2006 and 2007.ResultsWhile the Behavior Change Communication Program has made significant strides in educating and empowering young women to negotiate more consistent condom use with sexual partners, the gendered economic inequalities and power imbalances within rural and semi-urban Namibian society that favor men hinder further advancement towards positive behavioral change for HIV prevention and also hinder the development of the loving relationships sought by some sex workers.ConclusionThis study found that sex workers and transactional sex encounters are heterogeneous entities dependent upon the characteristics of the man (known, stranger, wealthy, attractive to the woman) and the woman (in financial need, desiring love). These features all influence condom use. The 3 E's 'education, empowerment and economic independence' are critical factors needed to encourage and facilitate consistent condom use to prevent HIV transmission. Without financial independence and occupational alternatives building on their health education and empowerment, women who engage in sex work-and transactional sex more generally-will remain largely marginalized from Namibian society, and will continue engaging in risky sexual practices that facilitate HIV acquisition and transmission throughout the community.
Highlights
There is little published research investigating sex work in Namibia, in rural areas
Our research has revealed several characteristics and experiences of women who engage in sex work in rural Namibia which help to understand the limitations of the effectiveness of the Behavior Change Communication (BCC) program
Through this exploratory study aiming to elucidate and highlight the experiences and views of informal female sex workers in the Oshakati area of Namibia, it emerged that a KAB approach alone is insufficient to achieve safer sexual practices, including regular condom use
Summary
There is little published research investigating sex work in Namibia, in rural areas. The aim of this paper was to determine the views of women engaged in sex work in the Oshakati area of Namibia concerning the main factors influencing their use, or non-use, of male condoms during transactional sexual exchanges. Educational and behavior change programs targeting high-risk individuals (e.g. female sex workers) and aiming to increase their use of male condoms have been implemented in efforts to prevent HIV transmission [4]. These programs have met with varying levels of success, with low rates of condom use amongst sex workers in many LMICs, including Namibia, identified in the limited available data [5,6]. The two studies conducted on sex work in Namibia are not in the peer-reviewed literature and have focused on the legalities of sex work in urban environments [17,18]
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