Elsevier

Social Science & Medicine

Volume 54, Issue 2, January 2002, Pages 179-192
Social Science & Medicine

Women who sell sex in a Ugandan trading town: life histories, survival strategies and risk

https://doi.org/10.1016/S0277-9536(01)00027-2Get rights and content

Abstract

Little is known about the background of commercial sex workers in Africa. This study investigated how women in a trading town on the trans-Africa highway in southwest Uganda become involved in commercial sex work, which factors contribute to their economic success or lack of success, and what effect life trajectories and economic success have on negotiating power and risk behaviour. Over the course of two years detailed life histories of 34 women were collected through recording open, in-depth interviews, the collection of sexual and income and expenditure diaries, visits to the women's native villages, and participant observation. The women share similar disadvantaged backgrounds and this has played a role in their move into commercial sex. They have divergent experiences, however, in their utilisation of opportunities and in the level of success they achieve. They have developed different life styles and a variety of ways of dealing with sexual relationships. Three groups of women were identified: (1) women who work in the back-street bars, have no capital of their own and are almost entirely dependent on selling sex for their livelihood; (2) waitresses in the bars along the main road who engage in a more institutionalised kind of commercial sex, often mediated by middlemen and (3) the more successful entrepreneurs who earn money from their own bars as well as from commercial sex. The three groups had different risk profiles. Due partly to their financial independence from men, women in the latter group have taken control of sexual relationships and can negotiate good sexual deals for themselves, both financially and in terms of safe sex. The poorer women were more vulnerable and less able to negotiate safer sex. A disadvantaged background and restricted access to economic resources are the major reasons for women gravitating to commercial sex work. Various aspects of personality play a role in utilising income from commercial sex to set up an economic basis that then makes the selling of sex unnecessary. This has implications for interventions, and part of the longer-term solution should lie in improving the economic position of women vis-à-vis men.

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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