期刊论文详细信息
International Journal for Equity in Health
Benefits and constraints of intimate partnerships for HIV positive sex workers in Kibera, Kenya
Kimberly Sharpe2  Elizabeth Ngugi4  Mikael Jansson1  Helga Hallgrimsdottir1  Eric Roth3  Cecilia Benoit1 
[1] Department of Sociology, University of Victoria, Victoria, Canada;Centre for Addictions Research of BC and Department of Sociology, University of Victoria, Victoria, Canada;Depart of Anthropology, University of Victoria, Victoria, Canada;Centre for HIV Prevention and Research, University of Nairobi, Nairobi, Kenya
关键词: Kenya;    Empowerment approach;    Resource-constrained countries;    HIV;    Female sex workers;    Intimate partnerships;   
Others  :  811389
DOI  :  10.1186/1475-9276-12-76
 received in 2013-02-01, accepted in 2013-08-22,  发布年份 2013
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【 摘 要 】

Introduction

Research on the intimate partnerships of female sex workers (FSWs) tends to focus on the risks associated with these relationships. This paper takes as its starting point that the situation of FSWs is better understood by including knowledge of the benefits of their intimate partnerships. Specifically, we employ the conceptual framework provided by emergent research examining intimacy as a complex fusion of affective and instrumental dimensions among sex workers. This perspective allows us to frame information about FSWs’ intimate partnerships within a behaviour-structural approach that is helpful for identifying how intimate partnerships can be a source of both benefit as well as increased risk to FSWs.

Methods

Our results are based on a mixed-methods study carried out in the summer of 2011 in Kibera, Kenya. We conducted face-to-face interviews (n=30) with a non-probability sample of FSWs stratified by age who self-identified as Human Immune Virus positive (HIV+). We asked about participants’ involvement in current and past intimate partnerships, and whether these relationships had a positive or negative impact on their health and well‒being.

Results

Participants currently in intimate partnerships had fewer clients and thus lower incomes than those without intimate partnerships. Participants presently with partners were also more likely to receive some financial support from partners, to report lower intimate partner violence, and to narrate higher partner emotional support and greater assistance with medications. These participants were also more likely to have disclosed their sex work and HIV+ statuses to their partners. Intimate partnerships, on the other hand, showed increased risk of economic vulnerability and emotional dependence for FSWs. This became especially problematic for those participants in fragile relationships. Despite these variations, none of the differences between the two groups were statistically significant.

Conclusions

Intimacy and transactional relations are bound up with one another and intersect with the structural realities and vulnerabilities; this is the case for sex workers in well-resourced and resourced-constrained countries alike. Rather than treating intimate partnerships as distinct from transactional relationships, FSWs’ relationships should be viewed on a continuum of risk and support.

【 授权许可】

   
2013 Benoit et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Benoit C, Shaver F: Critical issues and new directions in sex work research. Can Rev Sociol Anthropol 43:243-252.
  • [2]Weitzer R: Sociology of sex work. Annu Rev Sociol 2009, 35:213-234.
  • [3]Mgalla Z: Pool: sexual relationships, condom use and risk perception among female bar workers in north-west Tanzania. AIDS Care 1997, 9:407-416.
  • [4]Lowndes CM, Alary M, Gnintoungbé CA, Bédard E, Mukenge L, Geraldo N, Anagonou S: Management of sexually transmitted diseases and HIV prevention in men at high risk: targeting clients and non-paying sexual partners of female sex workers in Benin. AIDS 2000, 14:2523-2534.
  • [5]CM Egesah OB, Varkevisser CM, Habbema JDF, Voeten HA: Trabajadoras del sexo y sexo inseguro en áreas urbanas y rurales de Nyanza, Kenia: las parejas regulares podrían contribuir más a la transmisión de VIH que los clientes. Trop Med Int Health 2007, 12:174-182.
  • [6]Voeten HACM, Egesah OB, Ondiege MY, Varkevisser CM, Habbema JDF: Clients of female sex workers in Nyanza province, Kenya: a core group in STD/HIV transmission. Sex Transm Dis 2002, 29:444-452.
  • [7]Maman S, Mbwambo J, Hogan N, Kilonzo G, Campbell J, Weiss E, Sweat M: HIV-positive women report more lifetime partner violence: findings from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. Am J Public Health 2002, 92:1331-1337.
  • [8]Dunkle K, Jewkes R, Brown H, Gray G, McIntyre J, Harlow S: Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet 2004, 363:1415-1421.
  • [9]Farley M, Cotton A, Lynne J, et al.: Prostitution and trafficking in nine countries: an update on violence and posttraumatic stress disorder. J Trauma Pract 2003, 2:33-74.
  • [10]Kara S: Sex Trafficking: Inside the Business of Modern Slavery. New York, NY: Columbia University Press; 2009.
  • [11]Thuong NV, Nhung VT, Nghia KV, Tram LT, O’Farrell N: HIV in female sex workers in five border provinces of Vietnam. Sex Transm Infect 2005, 81:477-479.
  • [12]Ngugi E, Benoit C, Hallgrimsdottir H, Jansson M, Roth E: Partners and clients of female sex workers in an informal settlement in Nairobi, Kenya. Culture, Health & Sexuality 2011, 14:17-30.
  • [13]Kaufman J: Sex work, HIV and China. J Infect Dis 2011, 204(Suppl 5):S1218-S28.
  • [14]Tucker JD, Tuminez AS: Reframing the interpretation of sex worker health: a behavioral-structural approach. J Infect Dis 2011, 13(Suppl 5):S1206-1210.
  • [15]Tucker J, Kaufman J, Bhabha J, Kleinman A: Sex work and sexually transmitted infections in Asia: a biosocial analysis. J Infect Dis 2011, 204(suppl 5):S1203-S1205.
  • [16]Blanchard A, Mohan H, Shahmanesh M, Prakash R, Isac S, Ramesh B, Bhattacharjee P, Gurnani V, Moses S, Blanchard J: Community mobilization, empowerment and HIV prevention among female sex workers in south India. BMC Publ Health 2013, 13:234. BioMed Central Full Text
  • [17]Berlant L: Intimacy: a special issue. In Intimacy. Edited by Berlant L. Chicago, IL: University of Chicago Press; 2000.
  • [18]Dowsett GW, Williams H, Ventuneac A, Carballo-Diéguez A: ‘Taking it like a man’: masculinity and barebacking online. Sexualities 2008, 11:121-141.
  • [19]Poortinga W: Social relations or social capital? Individual and community health effects of bonding social capital. Soc Sci Med 2006, 63:255-270.
  • [20]Gross N, Simmons S: Intimacy as a double-edged phenomenon - an empirical test of Giddens. Soc F 2002, 81:531.
  • [21]Giddens A: The Transformation of Intimacy: Sexuality, Love, and Eroticism in Modern Societies. Stanford, California: Stanford University Press; 1992.
  • [22]Schoen R, Weinick RM: Partner choice in marriages and cohabitations. J Marriage Fam 1993, 55:408.
  • [23]Jamieson L: Intimacy transformed? A critical look at the ‘pure relationship’. Sociology 1999, 33:477-494.
  • [24]Holmes M: The precariousness of choice in the new sentimental order: a response to Bawin-Legros. Curr Sociol 2004, 52:251-257.
  • [25]Zelizer VAR: The Purchase of Intimacy. Princeton, N.J.: Princeton University Press; 2005.
  • [26]Bernstein E: Temporarily Yours: Intimacy, Authenticity, and the Commerce of Sex. Chicago: University of Chicago Press; 2007.
  • [27]Constable N: The commodification of intimacy: marriage, sex, and reproductive labor. Annu Rev Anthropol 2009, 38:49-64.
  • [28]Barton B: Dancing on the Möbius strip: challenging the sex war paradigm. Gend Soc 2002, 16:585-602.
  • [29]Vanwesenbeeck I: Another decade of social scientific work on sex work: a review of research 1990–2000. Annual review of sex research 2001, 12:242.
  • [30]Scambler G: Heath-related stigma. Sociol Health Illn 2009, 31:441-455.
  • [31]McCarthy B, Benoit C, Jansson M, Kolar K: Regulating sex work: heterogeneity in legal strategies. Annu Rev Law Soc Sci 2012, 8:255-271.
  • [32]Shannon K, Kerr T, Allinott S, Chettiar J, Shoveller J, Tyndall MW: Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work. Soc Sci Med 2008, 50:911-921.
  • [33]Jackson L, Augusta-Scott T, Burwash-Brennan M, Karabanow J, Robertson K, Sowinski B: Intimate relationships and women involved in the sex trade: perceptions and experiences of inclusion and exclusion. Health 2009, 13:25-46.
  • [34]Wu Z, Hart R: The effects of marital and nonmarital union transition on health. JMF 2002, 64:420-432.
  • [35]Brennan D: What’s Love Got to Do With it? Transnational Desires and Sex Tourism in the Dominican Republic. Durham: Duke University Press; 2004.
  • [36]Pruitt D, LaFont S: For love and money: romance tourism in Jamaica. Ann Tour Res 1995, 22:422-440.
  • [37]Peracca S, Knodel J, Saengtienchai C: Can prostitutes marry? Thai attitudes toward female sex workers. Soc Sci Med 1998, 47:255-267.
  • [38]Hunter M: The materiality of everyday sex: thinking beyond “prostitution”. Afr Stud 2002, 61:99-120.
  • [39]Robinson J, Yeh E: Transactional sex as a response to risk in Western Kenya. American Economic Journal. Appl Econ 2011, 3:35-64.
  • [40]Vermund S, DiClemente R, Gibney L, Ngugi E, Branigan E, Jackson D: Interventions for commercial sex workers and their clients. In Preventing HIV in Developing Countries. Biomedical and Behavioural Approaches. New York: Plenum Press; 1999:205-30.
  • [41]White L: Prostitution in Colonial Nairobi. Chicago: University of Chicago Press; 1990.
  • [42]McClintock A: The scandal of the whorearchy: prostitution in colonial Nairobi. Transition Magazine 1991, 52:94.
  • [43]Elmore-Meegan M, Conroy RM, Agala C: Sex workers in Kenya, numbers of client and associated risks: an exploratory survey. Reprod Health Matters 2004, 12:50-57.
  • [44]Chege M, Kabiru E, Mbithi J, Bwayo J: Childcare practices of commercial sex workers. East Afr Med J 2002, 79:382-389.
  • [45]Odek WO, Busza J, Morris CN, Cleland J, Ngugi EN, Ferguson AG: Effects of micro-enterprise services on HIV risk behaviour among female sex workers in Kenya’s urban slums. AIDS Behav 2009, 13:449-61.
  • [46]Fonck K, Els L, Kidula N, Ndinya-Achola J, Temmerman M: Increased risk of HIV in women experiencing physical partner violence in Nairobi, Kenya. AIDS Behav 2005, 9:335-339.
  • [47]De Smedt J: No Raila, no peace! Big man politics and election violence at the Kibera grassroots. Afr Aff 2009, 108:581-598.
  • [48]Yé Y, Muindi K, Konseiga A, Zulu EM, Beguy D, Bocquier P: Do migrant children face greater health hazards in slum settlements? Evidence from Nairobi, Kenya. J Urban Health 2001, 88(2):S266-81.
  • [49]Yé Y, Ezeh A, Ziraba AK, Kyobutungi C: The burden of disease profile of residents of Nairobi’s slums: results from a demographic surveillance system. Population Health Metrics 2008, 6:1. BioMed Central Full Text
  • [50]Unge C, Sodergard B, Ekstrom A, Carter J, Waweru M, Ilako F, Radnarsson A, Thorson A: Challenges for scaling up ART in a resource-limited setting: a retrospective study in Kibera, Kenya. J Acq Immun Def Synd 2009, 50:397-402.
  • [51]Roth EA, Jansson M, Hallgrimsdottir H, Benoit C, Ngugi EN: Family kinship patterns and female sex work in the informal urban settlement of Kibera, Nairobi, Kenya. Hum Ecol 2012, 40:397-403.
  • [52]Kovach M: Indigenous Methodologies: Characteristics, Conversations and Contexts. Toronto, Ontario: University of Toronto Press; 2009.
  • [53]Tashakkori A, Teddlie C: Handbook of Mixed Methods in Social & Behavioral Research. Thousand Oaks, Calif: SAGE Publications; 2003.
  • [54]Hesse-Biber SN, Leavy P: The Practice of Qualitative Research. Los Angeles: SAGE; 2011.
  • [55]Hochschild AR: The Commercialization of Intimate Life: Notes from Home and Work. Berkeley: University of California Press; 2003.
  • [56]Sanders T: A continuum of risk? The management of health, physical and emotional risks by female sex workers. Sociol Health Illn 2004, 26:557-574.
  • [57]Abel GM: Different stage, different performance: The protective strategy of role play on emotional health in sex work. Soc Sci Med 2011, 72:1177-1184.
  • [58]Cunradi CB, Caetano R, Clark C, Schafer J: Neighborhood poverty as a predictor of intimate partner violence among white, black, and Hispanic couples in the United States: a multilevel analysis. Ann Epidemiol 2000, 10:297-308.
  • [59]Lyngstad T, Jalovaara M: A review of the antecedents of union dissolution. Demogr Res 2010, 23:257-292.
  • [60]Hankivsky O, Reid C, Cormier R, Varcoe C, Clark N, Benoit C, Brotman S: Exploring the promises of intersectionality for advancing women’s health research. Int J Equity Health 2010, 9:1-15. BioMed Central Full Text
  • [61]Rekart M: Sex-work harm reduction. Lancet 2005, 366:2123-2134.
  • [62]Weitzer R: Legalizing Prostitution: From Illicit Vice to Lawful Business. New York: New York University Press; 2012.
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