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Oy S, Saing CH, Yem S, Chhoun P, Tuot S, Yi S. Post-Gender-Based Violence Services Utilization Among Female Entertainment Workers in Cambodia: A Cross-Sectional Study. Violence Against Women 2024; 30:2302-2319. [PMID: 36617944 DOI: 10.1177/10778012221147911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Little is known about service utilization among female entertainment workers (FEWs) after experiencing gender-based violence (GBV). This study explored factors associated with post-GBV service utilization among FEWs in Cambodia. We included 299 FEWs, who experienced any forms of GBV in the past 12 months. This study highlights low access (14.05%) to post-GBV services among FEWs. Factors associated with post-GBV services utilization were marital status, living conditions, mental health, and types of entertainment venues. To improve post-GBV services utilization, ensuring quality, and availability of services are required. Further research is needed to develop pathways toward a supportive environment for FEWs to access these services.
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Affiliation(s)
- Sreymom Oy
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Chan Hang Saing
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sokunthea Yem
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Pheak Chhoun
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Sovannary Tuot
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Center for Global Health Research, Touro University California, Vallejo, CA, USA
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Brennan RP, Fitzgerald L, Dean JA, Selvey L. 'Change creates change' - older female sex workers' experiences through the early COVID-19 pandemic. CULTURE, HEALTH & SEXUALITY 2024; 26:466-482. [PMID: 37355340 DOI: 10.1080/13691058.2023.2224869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 06/09/2023] [Indexed: 06/26/2023]
Abstract
COVID-19 and associated policy responses created unique social, economic and health risks for sex workers. Through semi-structured interviews we explored pre- and early COVID-19 experiences and work practices of ten cisgender female sex workers 50 years of age and older in Queensland, Australia, analysing the findings using a risk environment framework. Throughout early 2020, participants navigated a complex risk environment, managing economic needs, health and safety, occupational stigma and policing. Australia's policy responses altered the risks and opportunities available to participants. Half the participants continued sex work and half stopped sex work with some accessing economic support and withdrawing superannuation savings. Those who continued sex work drew on life and work experience to reassess changing health, stigma, and policing risks, and adapted their work strategies by increasing client screening and modifying services. Participants relied on information from peer networks and organisations to guide work practices but remained wary of contact tracing, police and the media. Decriminalisation of sex work and the strengthening of sex worker organisation and government partnerships are important in embedding equity in responses to ongoing and new public health threats.
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Affiliation(s)
- Rachael P Brennan
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Lisa Fitzgerald
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Judith A Dean
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Linda Selvey
- School of Public Health, The University of Queensland, Herston, QLD, Australia
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Brooks SK, Patel SS, Greenberg N. Struggling, Forgotten, and Under Pressure: A Scoping Review of Experiences of Sex Workers During the COVID-19 Pandemic. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1969-2010. [PMID: 37311934 PMCID: PMC10263380 DOI: 10.1007/s10508-023-02633-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic profoundly affected physical, mental, and economic well-being across the globe and has disproportionately affected certain vulnerable groups. This paper provides a scoping review of literature on the impact of the COVID-19 pandemic on sex workers, published between December 2019 and December 2022. Six databases were systematically searched, identifying 1009 citations; 63 studies were included in the review. Thematic analysis revealed eight main themes: financial issues; exposure to harm; alternate ways of working; COVID-19 knowledge, protective behaviors, fear, and risk; well-being, mental health, and coping; access to support; access to health care; and the impact of COVID-19 on research with sex workers. COVID-associated restrictions led to reduced work and income, leaving many sex workers struggling to cover basic needs; additionally, government protections excluded those working in the informal economy. Fearing the loss of their already reduced number of clients, many felt compelled to compromise both prices and protective measures. Although some engaged in online sex work, this raised concerns about visibility and was impossible for those without technological access or skills. Many feared COVID-19, but felt pressure to continue working, often with clients who refused to wear masks or share exposure history. Other negative impacts on well-being related to the pandemic included reduced access to financial support or health care. Marginalized populations (and especially those in professions which require close contact like sex workers) need further support and capacity-building within the community to recover from the impact of COVID-19.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK.
| | - Sonny S Patel
- Transcultural Conflict and Violence Initiative, Georgia State University, Atlanta, GA, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK
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Brody C, Harrison N, Yi S. Income loss and gender-based violence during the COVID-19 pandemic among female entertainment workers in Cambodia: a cross-sectional phone survey. BMC Public Health 2023; 23:281. [PMID: 36755266 PMCID: PMC9905764 DOI: 10.1186/s12889-023-15044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/12/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND In Cambodia, female entertainment workers (FEWs) are disproportionately affected by global and local disasters, such as the COVID-19 pandemic. To prevent the spread of COVID-19, the government imposed tight restrictions, including closures of entertainment venues, such as karaoke bars, beer gardens, nightclubs, or massage parlors, leading FEWs to face economic and social disruptions. This study aims to assess the relationship between income loss during the pandemic and gender-based violence (GBV) among FEWs in Cambodia to inform future disaster response programs. METHODS We conducted a phone survey in August 2021 with 369 randomly sampled FEWs from a national organization's email list. We used a structured questionnaire to ask the participants about job and income loss, food security, mental health, access to health services, and GBV. We fit a linear regression model to examine the differences in GBV experience between FEWs who lost all their income and those who lost partial income due to the COVID-19 pandemic. Key covariables comprised the number of dependents, smartphone ownership, internet access, food security, and mental health. Multivariable linear regression analysis was conducted. RESULTS The mean age (31.6 vs. 30.6), years of formal education (6.3 vs. 6.3), marital status (24.2 vs. 23.8 never married), and the number of children (1.3 vs. 1.1) of women reporting having lost all income were not significantly different from those who experienced partial income loss. Overall, GBV experiences were significantly higher in FEWs who lost all income than in those who lost partial income (62.9% vs. 47.4%, p = 0.03). Controlling for the number of dependents, smartphone ownership, and food security, the adjusted odds ratio for GBV was significant in the adjusted model (AOR = 1.23 (1.08-1.40), p = 0.001) indicating that those who experienced total income loss were more likely to experience GBV than those who experienced partial income loss. In addition, they were significantly less likely to be food secure (p = 0.04), less likely to own a smartphone (p = 0.02), and had more dependents (p < 0.001). CONCLUSION Disaster response programs should consider the implications of safety measures and government support for both formal and informal workers regarding safety, food access, and mental health support. Food assistance programs should target the most vulnerable informal sector workers during crises.
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Affiliation(s)
- Carinne Brody
- College of Education and Health Sciences, Public Health Program, Touro University California, Vallejo, CA, USA.
| | - Natasha Harrison
- grid.47840.3f0000 0001 2181 7878School of Public Health, University of California, Berkeley, CA USA
| | - Siyan Yi
- grid.265117.60000 0004 0623 6962College of Education and Health Sciences, Public Health Program, Touro University California, Vallejo, CA USA ,grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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Sehgal N, Patni CB. Covid-19 and female sex workers in India: a journey of brutal reality. SN SOCIAL SCIENCES 2023; 3:53. [PMID: 36908485 PMCID: PMC9987386 DOI: 10.1007/s43545-023-00631-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 02/05/2023] [Indexed: 03/08/2023]
Abstract
The present paper is focused on the devastating effect of the Covid-19 pandemic on female sex workers (FSWs) in India and the globe. In Indian scenario, it emphasises on historical factors and theoretical frameworks that explicates the ceaseless exploitation of FSWs even before the pandemic. This inquiry analyses the efficacy of legislative and judicial endeavours taken with regard to FSWs. It highlights the role of non-governmental organisations and sex workers' community, actively working in providing support to the FSWs. Here, we attempt to document the scattered information from various reports regarding sex workers and prostitution. Literature search was done through search engines like Science Direct, Google Scholar and PubMed using keywords such as "COVID-19 pandemic" "sex workers", "prostitutes", "health", and "policies". Web hits from Google Scholar were collected using a Boolean search and retrieval method involving sex workers and the "AND" operator. During Covid-19 pandemic, due to stigmatisation of their profession FSWs are majorly excluded from government relief programs and health services. In India, the existing laws for FSWs are rigid in nature. They emphasize on prohibition of prostitution. There is an urgent need in India to move towards a substitute model which embody a flexible decriminalisation policy for sex workers. By studying relevant literature on the present topic the gap between policy formulation and implementation was identified. In case of India, it outlines recommendations, in particular providing immediate aid and relief, issuance of temporary documentation to sex workers.
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Affiliation(s)
- Neha Sehgal
- Department of Political Science, Faculty of Social Sciences, Daulat Ram College, University of Delhi, Delhi, 110007 India
| | - Chandra Bhushan Patni
- Department of Political Science, Faculty of Social Sciences, Hindu College, University of Delhi, Delhi, 110007 India
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Tan RKJ, Ho V, Sherqueshaa S, Dee W, Lim JM, Lo JJM, Teo AKJ, O'Hara CA, Ong C, Ching AH, West BS, Wong ML. COVID-19 and the shifting organisation of sex work markets in Singapore. CULTURE, HEALTH & SEXUALITY 2022; 24:1744-1759. [PMID: 34913401 DOI: 10.1080/13691058.2021.2014975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
While past studies have sought to capture how the COVID-19 pandemic has impacted on the health and sexual lives of sex workers internationally, less attention has been paid to the reorganisation of sex markets as a result of COVID-19. We conducted a sequential exploratory mixed methods study using in-depth interviews, cyber ethnography and surveyor-administered structured surveys among sex workers. We report two key findings on how the pandemic has impacted sex markets in Singapore. First, the organisation of sex markets shifted as a result of lockdown and associated movement control measures. This shift was characterised by the out-migration of sex workers, the reduction in supply and demand for in-person sex work, and a shift towards online spaces. Second, we found that sex workers experienced greater economic hardship as a result of such changes. Given the potential shifts in sex markets as a result of the pandemic, we adopt a World Health Organisation Health Workplace Framework and Model to identify interventions to improve the occupational safety and health of sex workers in a post-COVID-19 era.
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Affiliation(s)
- Rayner Kay Jin Tan
- University of North Carolina Project-China, Guangzhou, China
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | | | | | - Jane Mingjie Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jamie Jay-May Lo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alvin Kuo Jing Teo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Clarence Ong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ann Hui Ching
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Brooke S West
- School of Social Work, Columbia University, New York, NY, USA
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Aantjes C, Muchanga V, Munguambe K. Exposed and unprotected: Sex worker vulnerabilities during the COVID-19 health emergency in Mozambique. Glob Public Health 2022; 17:3568-3582. [PMID: 35748776 DOI: 10.1080/17441692.2022.2092184] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Measures to contain the spread of COVID-19 have been shown to disproportionately affect the marginalised groups in our societies. We studied the impacts of national restrictions on young adult sex workers in Mozambique, and actions at individual, governmental and civil society level to mitigate against these impacts. The country case study was part of a multi-country qualitative research, including fifty-four semi-structured interviews with female sex workers (N = 38), outreach workers (N = 10) in Maputo and Quelimane, and informants with key positions in national COVID coordination bodies, the Ministry of Health and civil society organisations (N = 7). While restrictions impacted all sex worker participants, the COVID crisis was found to deepen existing class differences and further incite violence against the most visible and economically vulnerable category of street-based sex workers. Parallel enforcement of morals against this group of 'urban undesirables' resulted in bodily harm and further degradation of the female sex worker under the guise of COVID emergency decrees, while restrictions weakened protection from peers and outreach workers against abuse by the police and other perpetrators. The State needs to act against unlawful police action and include impact mitigation strategies in its public health response to COVID in order to protect the most vulnerable.
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Affiliation(s)
- Carolien Aantjes
- Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa
| | - Vasco Muchanga
- Faculty of Medicine, Community Health Department, Sexual and Reproductive Health Unit, Eduardo Mondlane University, Maputo, Mozambique
| | - Khátia Munguambe
- Faculty of Medicine, Community Health Department, Sexual and Reproductive Health Unit, Eduardo Mondlane University, Maputo, Mozambique
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Crankshaw TL, Muparamoto N, Chareka S, Ngwenya P. Intersectional vulnerabilities and differential impacts of COVID-19 responses on young people who sell sex in Zimbabwe. CULTURE, HEALTH & SEXUALITY 2022:1-15. [PMID: 35913510 DOI: 10.1080/13691058.2022.2101068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
Abstract
The varying impact of the COVID-19 pandemic on different populations has brought into focus the pre-existing inequalities which shape vulnerabilities amongst marginalised and key populations. More nuanced approaches which understand intersectional vulnerabilities and differential impacts of the pandemic on gender and sexuality diversity within these groups are required. We investigated the economic, social and health impacts of COVID-19 on young people of diverse genders and sexualities who sell sex (16-24 years) in Zimbabwe. We found that all groups had heightened vulnerability to economic and social hardship during the first two COVID waves in Zimbabwe. However, vulnerability was unequally distributed by geography and socio-economic position, as well as by gender and age, both within and between groups of participants. With limited funding resources for the promotion of sexual and reproductive health and rights in the push for universal health coverage, nuanced approaches which include analysis of multidimensional vulnerabilities between and within groups is required to develop the most cost effective and impactful policy and programme interventions.
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Affiliation(s)
- Tamaryn L Crankshaw
- Health Economics and HIV and AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa
| | - Nelson Muparamoto
- Wits Centre for Diversity Studies, University of the Witwatersrand, Johannesburg, South Africa
- Demography Settlement and Development, University of Zimbabwe, Harare, Zimbabwe
| | - Samantha Chareka
- Health Economics and HIV and AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa
| | - Precious Ngwenya
- Department of Development Studies, Faculty of Humanities and Social Sciences, Lupane State University, Lupane, Zimbabwe
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Wirawan GBS, Wardhani BDK, Pradnyani PE, Nurhalina A, Sulaiman N, Sukmaningrum E, Wulandari LPL, Januraga PP. Behavioral Changes, Adaptation, and Supports among Indonesian Female Sex Workers Facing Dual Risk of COVID-19 and HIV in a Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1361. [PMID: 35162384 PMCID: PMC8835319 DOI: 10.3390/ijerph19031361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 02/01/2023]
Abstract
The objective of this study is to explore the impacts of COVID-19 and changes taking place among the Indonesian female sex worker (FSW) community during the COVID-19 pandemic and the predictors of these changes. We conducted a cross-sectional online survey and selected the participants using a purposive snowball sampling technique. Incentives were provided to participants in the form of a 5 USD e-wallet balance. Variables of interest included adaptation to online sex work, adherence to COVID-19 prevention measures during sex work, number of clients, income reduction, social support, condom access, and condom use frequency. Sociodemographic data and COVID-19 fear index values were also collected. Final analysis included 951 FSWs, of whom 36.4% of had adapted to online sex work and 48.6% had practiced COVID-19 prevention measures. Major reductions in client frequency and income were reported by 67.8% and 71.1% of respondents, respectively. However, only 36.3% of FSWs reported they had ever received any form of social support from any parties, public or private. Meanwhile, 16.7% encountered difficulties in accessing condoms and 12.5% reported less frequent condom use during the pandemic. Easy access to condoms was the main factor influencing the frequency of condom use. As expected, staying in employment protected FSWs from major income loss, while education and younger age predicted adaptive behavioral changes, such as taking up online sex work. The COVID-19 pandemic has disrupted access to socioeconomic support systems and HIV prevention services among FSWs and has further exposed them to the dual jeopardy of HIV and COVID-19 infections.
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Affiliation(s)
- Gede Benny Setia Wirawan
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar 80113, Indonesia; (G.B.S.W.); (B.D.K.W.); (P.E.P.)
| | - Brigitta Dhyah K. Wardhani
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar 80113, Indonesia; (G.B.S.W.); (B.D.K.W.); (P.E.P.)
| | - Putu Erma Pradnyani
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar 80113, Indonesia; (G.B.S.W.); (B.D.K.W.); (P.E.P.)
| | | | | | - Evi Sukmaningrum
- Faculty of Psychology, Atma Jaya Catholic University of Indonesia, Jakarta 12930, Indonesia;
| | - Luh Putu Lila Wulandari
- Kirby Institute, University of New South Wales, Sydney 2033, Australia;
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar 80113, Indonesia
| | - Pande Putu Januraga
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar 80113, Indonesia; (G.B.S.W.); (B.D.K.W.); (P.E.P.)
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar 80113, Indonesia
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