AIDS, mobility and commercial sex in Ethiopia: Implications for policy

Abstract

Since the emergence of the AIDS pandemic in sub-Saharan Africa, male mobility has been highlighted as one of the reasons for the spread of the disease with men employing the services of commercial sex workers while away from home. However, sex workers’ mobility and the implications of this for their access to prevention services, has largely been ignored. This paper, based on multi-method qualitative research with 60 young sex workers in two Ethiopian towns, reveals that sex workers are highly mobile, moving in order to attract a wider or different client base, for adventure and to conceal illnesses which might be associated with AIDS. In addition, sex workers are affected by restrictions on their movements, with girls working in bars and red-light areas having little free time to access projects. This paper advocates that policy approaches need to take account of this mobility in three ways: first, by exploring ways for girls to access information and maintain contact with support structures while moving between places of work; second, by building the capacity of sex workers to take greater control over decision-making in their day-to-day lives and third, by developing outreach strategies for taking services into bars and red-light areas.

Acknowledgments

This research was funded by a Nuffield Foundation Social Science Small Grant, however, the views and opinions contained in the paper are entirely my own. I gratefully acknowledge the institutional support of the Institute of Ethiopian Studies, Addis Ababa University and Goal Ethiopia. I would also like to thank Abeba Amare for her work as a research assistant on the project and acknowledge my indebtedness to the girls who participated in the project.

Notes

1. Mobility processes refer to the movements engaged in by commercial sex workers including movements between work locations as well as between different towns. In addition, restricted mobility is also considered part of these processes.

2. The Emperor's camp was a large establishment that moved around the country under the direction of the current ruler.

3. For this paper, the age of the participants is not significant although teenage girls may be more mobile than older commercial sex workers if they do not have children or other household obligations.

4. Within these three categorisations there is a diverse range of experiences. It is the poorest groups that were principally the focus of this research.

5. Although it is acknowledged that sex work definitions can be complex, particularly in poor communities where sex may be exchanged for income or other needs at times of hardship, this paper focuses specifically on girls who exchange sex for cash with a variety of (mainly unknown) men as their main source of livelihood.

6. Tella and Tej are locally produced traditional drinks that are sold in small bars often the size of one room.

7. As shown later in this paper, it was more difficult for red-light workers to participate in the research due to constraints on their mobility, hence the relatively smaller number of participants engaging in this type of sex work.

8. Pseudonyms are used to maintain confidentiality.

9. Business is the term used by the girls when referring to sex work.

10. Not all girls who know or suspect they are HIV-positive are able to stop doing business.

11. The women's room is a room at the back of the bar where the girls are allowed to keep their belongings and sleep.