(P177) Understanding the Structural Factors that Influence Female Sex Work in Kampala

Background: Structural factors can present barriers for uptake of and adherence to existing HIV prevention products like oral PrEP among people at high risk of HIV infection, including female sex workers (FSWs). It is important to understand these structural factors that could potentially influence long-acting PrEP uptake among FSWs. The aim was to explore the structural factors that influence female sex work in Kampala and investigate any major differences in individual characteristics among them.


Methods: We collected qualitative data using semi-structured interviews. Ten FSWs were sampled randomly from women attending a clinic and operating in bars, lodges and on the streets. Ten others were sampled from social media and snowballing, with the initial contact being the social media contact and nine peer referrals. Topics included reasons for joining or leaving sex work, work locations, relationships with clients and peers, interaction with authorities, impact of criminalisation, and perceived or experienced stigma.


Results: Participants were aged 23-43 years. The highest level of education registered from the cohort was senior four, while the lowest level in the snowball sample was diploma. The reported price for condomless sex ranged from 10,000 - 50,000 shillings in the cohort, and 1,000,000 - 7,400,000 shillings in the snowball sample. The structural factors that influence female sex work in Kampala include regulations outlawing sex work, violent and abusive relationships with clients and authorities, factors that affect entry into and exit from sex work, factors that affect how sex workers are organised and how they work, and stigma. Results indicate differences among FSWs in the two samples, with the snowball sample having higher income, higher education, and using social media and online platforms more than those that work on streets, in bars and in lodges.



Conclusion: This study documents a section of FSWs with higher education levels, earnings from sex work, and operating mostly in an online or private environment. In line with the UNAIDS strategy of leaving no one behind and reaching the populations at the greatest need of care, interventions should be designed to reach all FSWs in Kampala, including FSWs that do not work in bars, lodges and streets.