Interpersonal and structural contexts of intimate partner violence among female sex workers in conflict-affected northern Uganda

ABSTRACT

Intimate partner violence (IPV) is the most prevalent form of violence against women, yet remains under-researched among sex workers in sub-Saharan Africa. We explored the interpersonal and structural determinants of recent IPV among female sex workers in northern Uganda. This analysis drew on data from a community-based cross-sectional study (conducted May 2011–January 2012), involving 379 female sex workers in Gulu, northern Uganda. Using logistic regression and multivariable modeling, we examined the correlates of recent male-perpetrated physical or sexual IPV. Of 379 women with noncommercial partners, 59 percent reported having experienced recent moderate/severe physical or sexual IPV. Reporting recent client violence (adjusted odds ratio (AOR): 3.67; 95 percent confidence interval [CI]: 2.31–5.83), doing what their partner wanted (AOR: 2.46; 95 percent CI: 1.46–4.13), and forced sexual debut (AOR: 1.92; 95 percent CI: 1.20–3.05) were independently associated with moderate/severe IPV; recent police arrest and/or incarceration were/was marginally significantly associated with IPV (AOR: 2.25; 95 percent CI: 0.86–5.88, p = 0.097). Greater odds of IPV among sex workers were associated with recent workplace violence, forced sexual debut, and gendered power dynamics favoring male partner control. Programs and policies promoting the safety and health of marginalized women and addressing gender dynamics and violence are needed.

KEYWORDS:

• Intimate partner violence
• sex workers
• sub-Saharan Africa
• Uganda

Acknowledgments

The authors wish to thank all those who contributed their time and expertise to this project, particularly participants, Acholi interview and peer/sex worker outreach teams, TASO Gulu community advisory board and humanitarian/refugee, youth, women, and sex work partner agencies. We wish to acknowledge in particular Esther Achan, Miriam Akello, Katie Muldoon, Jacky Ayat, Beatrice Baraka, Bibian Achan, Grace Lakot, Winnie Amunu, Andrew Mijumbi Ojok, Paul Nguyen, and Sabina Dobrer for their research and administrative support.

Funding

This research was supported through a CIHR Team Grant in Gender, Violence and Health. SG is supported by the Canadian Institute of Health Research (CIHR). KS is supported by Canada Research Chair in Global Sexual Health and HIV/AIDS and Michael Smith Foundation for Health Research.

Additional information

Funding

This research was supported through a CIHR Team Grant in Gender, Violence and Health. SG is supported by the Canadian Institute of Health Research (CIHR). KS is supported by Canada Research Chair in Global Sexual Health and HIV/AIDS and Michael Smith Foundation for Health Research.