Abstract: Crossroads of Choice: Understanding the Factors Influencing Decisions to Transition from Sex Work Among Women in Uganda (Society for Social Work and Research 29th Annual Conference)

Please note schedule is subject to change. All in-person and virtual presentations are in Pacific Time Zone (PST).

866P Crossroads of Choice: Understanding the Factors Influencing Decisions to Transition from Sex Work Among Women in Uganda

Schedule:
Sunday, January 19, 2025
Grand Ballroom C, Level 2 (Sheraton Grand Seattle)
* noted as presenting author
Jennifer Nattabi, MSW, Doctoral Student, Washington University in Saint Louis, St. Louis, MO
Ozge Sensoy Bahar, PhD, Research Associate Professor, Washington University in St. Louis, MO
Josephine Nabayinda, Msc, Doctoral student, Washington University in Saint Louis, Saint Louis, MO
Proscovia Nabunya, PhD, Assistant Professor, Washington University in Saint Louis, MO
Joshua Kiyingi, MSTAT, Doctoral Student, Washington University in St. Louis, St. Louis, MO
Samuel Kizito, MD, MS, Research fellow, Washington University in St. Louis, St Louis, MO
Flavia Namuwonge, MBA, Doctoral Student, Washington University in St. Louis, MO
Edward Nsubuga, Master's Student, Washington University in St. Louis, MO
Susan Witte, PhD, LCSW, Professor, Columbia University, New York, NY
Fred Ssewamala, PhD, Professor, Washington University in Saint Louis, Saint Louis, MO
Background and Purpose

Women Engaged in commercial Sex Work (WESW) are exposed to behavioral, biological, and structural factors that exacerbate their risk to HIV infection and other sexually transmitted infections. While commercial sex work may appear voluntary, WESW are more likely to be constrained to selling sex due to limited viable alternatives. To effectively support this vulnerable group of women, it is critical to understand factors that facilitate and impede their decisions to transition from sex work into other careers or jobs. The current study explored women’s decision to transition from sex work into other careers or jobs.

Methods

Semi-structured in-depth interviews were conducted with 53 WESW aged 20-47 enrolled within a larger study-Kyaterekera study, a randomized clinical trial (N=542) implemented in 19 HIV hotspots in the Southern region of Uganda. Participants were selected based on their intervention attendance (high/medium/low attendance). The interviews were conducted in Luganda the widely spoken language in the study area to explore the factors influencing women’s decisions to from transition from sex work to other jobs or careers. The main interview question used for this study was, “What are some of the factors that may influence whether you would transition from sex work to other jobs or vocations?”. All interviews were audio-recorded, transcribed verbatim and translated into English. Thematic analysis in Dedoose software was used to analyze the data.

Results

Participants reported three primary types of decisions, including considering leaving sex work, deciding to leave, and continuing sex work. The emerging themes from the interviews were categorized into individual and structural level facilitators and barriers to leave sex work. Individual level factors included issues of stigma and discrimination, aging, physical and sexual violence as factors that facilitated women’s decision to leave sex work. While income related factors such as the need for start-up capital, gaining financial stability, getting an alternative source of income, and planning for future prospects were identified as structural related barriers to leaving sex work.

Conclusion and Implications

Our study highlights the complex decision-making processes among WESW as they navigate transitions to alternative jobs or careers. By advocating for multifaceted interventions and policies tailored to the diverse challenges faced by WESW, our study contributes to a more informed approach to supporting their transition out of sex work.

Key words: Women Engaged in Sex Work, Transition from sex work, Commercial sex work.