Understanding the financial lives of female sex workers in Abidjan, Côte d’Ivoire: implications for economic strengthening interventions for HIV prevention

ABSTRACT

Many women’s decisions about whether and how to participate in sex work are driven by financial considerations. Despite the recognized importance of economic factors in HIV risk among female sex workers (FSWs), many HIV prevention programs focus narrowly on sexual risk behaviors. We collected data on the financial practices of FSWs in Abidjan, Côte d’Ivoire, to better inform economic strengthening programs for HIV risk reduction with this population. We conducted “walk-along” participant observations (N = 74) during FSWs’ daily non-working routines and analyzed resultant notes using qualitative thematic analysis. We used a financial diary methodology to collect detailed quantitative data on income, spending, savings and lending from a sub-sample of participants (n = 33) over six weeks; these data were analyzed using descriptive statistics. All women in our sample reported sex work as their primary source of earned income. Median weekly income was roughly US $114, with a wide range across the sample and from week to week. Cash expenses related primarily to routine needs (e.g., food, housing, transportation) and accounted, on average, for approximately 90% of weekly spending. Around one-quarter of weekly expenses were directly associated with sex work (e.g., clothing, beauty products, and alcohol). FSWs held “savings” in boxes, mobile money platforms, informal savings groups, or banks, though most withdrew cash from these funds frequently. These findings suggest that this group of FSWs in Abidjan, Côte d’Ivoire, are not cash-poor: median weekly income is greater than the estimated Ivoirian weekly per capita gross national income. Yet the erratic nature of income alongside routine spending needs suggests that effective economic strengthening programs in this context should include financial management education, group-based savings and lending, and links to formal financial institutions. These economic strengthening activities hold promise to empower FSWs financially for downstream HIV-risk reduction benefits by building economic resilience to reduce financially-driven sexual risk decisions.

KEYWORDS:

• Key populations
• sex work
• women
• HIV prevention
• economic strengthening
• structural drivers
• Côte d’Ivoire
• West Africa

Acknowledgments

We would like to thank the many people and organizations that made this research possible. We are grateful to Dr. Marguerite Niangoin Thiam, Coordinating Director for Highly Vulnerable Populations within the Program in the Fight Against AIDS at the Ivoirian Ministry of Health at the time of the study for her support and guidance on the development of this project. We extend our gratitude to colleagues at Espace Confiance, Blety, Population Services International, and Heartland Alliance, without whose collaboration and assistance we could not have gained entrée to sex worker communities. Additionally, we are thankful to la brigade de lutte contre la drogue et les stupéfiants for helping ensure the security of our data collection team on the ground. FHI 360’s country office in Abidjan also provided critical logistical support and advice, while colleagues Amy O’Regan and Jenae Tharaldson assisted in the preparation of this manuscript. And finally, we sincerely appreciate the time, honesty, and richness of detail shared by the women who participated in this research.

Disclosure statement

The authors have no competing interests to declare.

ORCID

Emily Namey http://orcid.org/0000-0003-3200-1633

Additional information

Funding

This study was produced under United States Agency for International Development (USAID) Cooperative Agreement No. AID-OAA-LA-13-00001 and was made possible by the generous support of the American people through USAID and the United States President’s Emergency Plan for AIDS Relief. The contents are the responsibility of FHI 360 and do not necessarily reflect the views of USAID or the United States Government.