Exploring the emotional strength of sex workers

Despite experiencing difficulties throughout their lives, women who sell sex display high levels of resilience, research from Kenya has found.

What is the research about?

The resilience of women who sell sex in Nairobi, Kenya. Researchers interviewed 40 women aged 18 to 45.

Why is this research important?

Sex work is illegal in Kenya, and sex workers face high levels of stigma, marginalisation and abuse. Women in Kenya who sell sex are also five times more likely to have HIV than other women.

Understanding how this impacts on sex workers’ lives is key for designing HIV services and other support that works for them.

What did they find out?

Experience of abuse and violence were common

All participants experienced difficulties either as children, in their relationships or in sex work. Most experienced difficulties in all three.

Childhood experiences of poverty and sexual and physical abuse were common. All had left school early. All but one had become pregnant as teenagers or young women, and most had married or lived with their male partner. Partner violence was common.

Most of the women became sex workers after leaving their partner because they needed to provide for their children and other work didn’t pay enough.

Sex work was difficult. Experience of clients being violent, abusive and refusing to wear condoms were common. Harassment and abuse from police was common, as was stigma from the wider community. Most hid what they did for a living.

These experiences led to mental health conditions, such as depression, yet there was little mental healthcare available. Some used alcohol and/or drugs, such as cannabis or khat, to ease their pain. All but one woman planned to leave sex work in the future.

Motherhood as a source of strength

Despite these difficulties, most participants described sex work as a relief because it meant they could provide for their children and other family members.

The main reason women sold sex was to give their children a better life. As Phiona, 37, says: “I sell sex and pay school fees for my children. I pray to God that he helps them to pass the level that I reached.”

Being mothers was the biggest source of strength for participants and helped them build resilience.

Solidarity and hope

Most sex workers benefited, and even thrived, due to support from other sex workers. This included financial and emotional support, sharing health information and jointly engaging with HIV services. As Almasi, 28, describes: “Like in case of a condom burst you advise your friend to go for the 28-days drug and if she does not know where the hospital is you take her.”

Another source of resilience came from regular clients who participants said treated them with respect.

Some women had plans to find another job. Some had joined savings groups or micro-enterprise schemes to start their own business. Others hoped to meet a rich man or prayed to God for change.

What does this mean for HIV services?

Sex workers are likely to be in a support network with other sex workers. Tapping into these support systems by working with key sex workers in the networks is an effective way to provide HIV services. It is vital to ensure sex workers lead or co-lead any support they receive, due to how influential peers are.

Given the abuse and violence sex workers face, providing mental health support, post-violence care, and substance use services is important.

Many sex workers in this study were looking for alternative work. This suggests that providing training, vocation and education schemes that sex workers are interested in could also be useful.

Schemes that help adolescent girls stay in school are also important because this will give them more work options when they are older. Providing teenage girls with education and support for birth control, HIV prevention and dealing with abusive relationships is also vital.