Investigating social network preferences of sex workers in Hillbrow and their sexual health practices

Abstract

This research investigated harmful vaginal practices of female sex workers (FSW) in Hillbrow including the products they used to dry, tighten and cleanse the vagina. The main objective of the study was to understand the practices they engaged in, as well as to explore their beliefs and motivations for engaging in those practices and what the implications of introducing vaginal microbicides to this population will be and understanding their social networks. This research is crucial in understanding factors that contribute to HIV acquisition. Past research has indicated that the prevalence rates of HIV amongst sex workers tends to be higher than in the general population due to the nature of their work, therefore it is important to understand structural and behavioural factors that lead to increased susceptibility. In this study, purposive sampling was used to obtain a sample of FSW; and a total sample of 10 was reached from a private house in Hillbrow. The participants ages ranged from 21-43; and all women were self- identified sex workers. The study was qualitative in nature, employing in-depth interviews as the main method of data collection. All interviews were conducted in local languages of choice namely: English, Zulu and Sotho. Data were transcribed, translated and analysed thematically using scientific software Atlas Ti, Version 6.0. Key themes were drawn namely, sexual practices, social networks, life histories, and sex work health. Motivations for engaging in vaginal practices included: cleansing the condom content from the vagina, creating more competition, cleansing sperm after condom-breakage, to keep clients returning, to stop bleeding when on periods and to make sex nicer. Practices included washing with traditional and non-traditional products. The study demonstrated that there is still limited information regarding health risks that lead to higher levels of HIV acquisition. To address these it is important to understand a varied number of factors such as culture, behaviour, and psychosocial factors. Further, educational, prevention and empowerment interventions need to be developed incorporating key messages about harmful practices. At a national level, government educational campaigns and policies need to address this issue in relation to the unequal distribution of power between men and women, create equal opportunities and devise socio-economic solutions. Key Words: Sex work, Sexual practices, South Africa, Hillbrow, Social network