Women who sell sex in a Ugandan trading town: life histories, survival strategies and risk
Introduction
Of the 34.3 million people in the world who are living with HIV/AIDS, 24.5 million are in sub-Saharan Africa. Although prevalence has stabilised in Senegal and decreased in Uganda, it is increasing in much of the rest of Africa. In 1999 there were 4 million new infections. There are now 16 countries in Africa in which more than one-tenth of the adult population aged 15–49 is infected with HIV. Infection rates are higher in women than in men (12 women for every 10 men). UNAIDS reports “frighteningly high” prevalence rates among young women under 25. For example, 6 out of 10 women aged 20–24 in the South African town of Carletonville tested positive for HIV (UNAIDS, 2000, pp. 6–12).
High rates of HIV infection have also led to a steep rise in mortality and an increase in the numbers of orphans throughout sub-Saharan Africa. It has been estimated that in countries with an adult HIV prevalence of just under 10%, almost 80% of deaths in young adults are HIV-related. To date, AIDS has left behind 13.2 million orphans, 95% of whom are in Africa.
The literature on HIV infection in Africa has often focused on commercial sex workers as an important risk group, and they have been described as constituting a reservoir of infection because of the large number of sexual partners involved (D’Costa, Plummer, & Bowmer, 1985; Nzilambi et al., 1991; Orubuloye, Caldwell, Caldwell, & Santow, 1994; Kemigabo, 1997; Asiimwe-Okiror, Musinguzi, Agaba, & Opio, 1999).
There has, however, been a reaction to this approach, as it stigmatises female “prostitutes” and ignores the multiple factors that place women at risk of contracting HIV (Day, 1988; Carovano, 1991; Seidel, 1993; Standing, 1992). Day (1988), in particular, warns against conceptualising prostitution as a universal phenomenon by merely defining it as sexual services that are exchanged for material goods. She points to the geographically and historically contingent variation, and to the influence of factors like the division of labour and gender ideology. Determining what counts as prostitution and placing different practices in their specific cultural contexts is vital to understanding these women's protection needs.
It has been argued, for example, that commercial sex workers in the West, who make a clear distinction between their professional and their private lives, are the best protected in their professional lives due to consistent condom use, despite the number of sexual partners (Day, 1988).
In sub-Saharan Africa, where commercial sex work is sometimes less easy to distinguish from other sexual relationships (Orubuloye et al., 1994), these women may not so readily dispose of strategies like consistent condom use to protect themselves (Heise & Elias, 1995; Tamale, 1997). Culturally embedded norms about sexuality often lead to sexual behaviour that puts both men and women at risk.1 To design adequate AIDS prevention, it is necessary to be informed about the realities of third world women (Heise & Elias, 1995).
It has often been assumed that commercial sex work is a result of economic necessity (Bassett & Mhloyi, 1991; Carovano, 1991; Larson, 1989; Pittin, 1983; Worth, 1989; Kemigabo, 1997; Sangare, 1997; Pappoe, 1997; Akinleye Olusoji & Modupe, 1999). However there are also studies that describe sex work as an alternative strategy for obtaining financial and social independence (Pickering et al., 1993; Mgalla & Pool, 1997; Little, 1973; Camara, 1997). Whatever the case may be, not all poor women become commercial sex workers.
In the study reported here, we were interested in three aspects of lives of women who sell sex:
- 1.
How did they come to be involved in commercial sex work?
- 2.
Which factors contributed to their economic success or lack of success as commercial sex workers?
- 3.
What effect do life trajectories and economic success have on negotiating power and risk behaviour?
In this paper we discuss these issues on the basis of a detailed study of the life histories of 34 women in a trading town in southwest Uganda. After a description of the study location and methods, we present some general information on the women and on marriage, relationships and patriarchy in the study area. We then present a discussion of sex work, condom use and the risk of HIV and STDs followed by short, representative life histories of three of the women.
Section snippets
Location
The study was carried out in a trading town settlement on the Trans-Africa highway, between Kampala and Masaka in southwest Uganda. The town, which had a population of about 6000 in 1991, is stretched out along the road that is its major reason for existence. Its economy is based on petty trade, smuggling and the provision of services of all kinds to passing truck drivers. It is also a trading centre for fish, agricultural produce and coffee. The buildings facing the road are mainly bars,
Methods
In this study we made use of life histories, participant observation and sexual diaries. The most important of these was the life history. The life histories of 34 women were recorded.
The detailed biography or life history can be used to study a specific individual or as a means of studying a whole group or culture. The subject may be a particularly gifted or otherwise special individual whose life story is unique or special in some way (e.g. Dwyer, 1982; Crapanzano, 1980), or a typical
The women
The median age of the women was 30 (range 20–55). The average age of first pregnancy was 16. On average, the women in this study had had 2 marriages and the women above 35 had 3.5 marriages. They had a medial of 2 children (range 0–7). Thirty-four of the women who participated in the study were Baganda. Four were Rwandese by origin; their parents having migrated to Uganda during periods of instability and the women were born and had grown up in Uganda. Kinyarwanda is their native tongue but in
Marriage, relationships and patriarchy
Among the patrilineal Baganda in our study area (and among most other ethnic groups in Uganda), authority over the upbringing of children belongs to the father's lineage, and the senga (father's sister) traditionally has responsibility for educating and guiding her brother's daughters on his behalf. The senga is like a female father (Muyinda, Kengeya-Kayondo, Pool, & Whitworth, 2000). The main function of the senga is to prepare young girls for marriage (Kisekka, 1973). This includes informing
Sex work, condom use and risk of HIV and STDs
The women in this study can be divided into three groups, depending on the type of bar work they do, their income, degree of independence and exposure to risk of HIV and STDs. Each of the cases presented below is a representative illustration of women from one of these groups. These groups of women do not constitute different groups in the sociological sense, but they are categories that are recognised as such by the local community.
First there are those who operate from or frequent back-street
Three life stories
In this section we present summaries of the life histories of three of the women. These stories are representative of the different kinds of life history in the study. They also illustrate the three groups of women that have been discussed in more detail in the previous section.
Discussion
In her study of sexual networks in the same trading town, Pickering distinguished between “high-”, “middle-” and “low-” class women. She initially made this distinction on the basis of the amount they charged for sex, but later found that these groups also coincided with distinct sexual networks: the “high-class” women mainly had customers from outside the town, whereas the “low-class” women mainly had sex with local men. She identified an intermediate group of women who had sex with local men,
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