Gulu, Uganda – A recent study conducted by Gulu and Lira Universities has unveiled that more than a third of commercial sex workers in Gulu City are married and residing with their partners. Dr. Felix Bongomin, a lecturer in Gulu University’s Faculty of Medicine and the lead investigator, presented these findings during the inaugural Gulu and Lira Universities Annual Scientific Symposium held at Bomah Hotel in Gulu City.
The study, carried out between February and March of this year, engaged 314 female commercial sex workers from 15 different hotspots within Gulu City. The research focused on understanding the use of dual contraception among these women, with financial support from the Centre for International Reproductive Health Training (CIRHT) via a research seeds grant for junior researchers.
The main aim of the research was to grasp the underlying factors and circumstances that lead married women to engage in commercial sex work. Dr. Bongomin clarified that the number of female commercial sex workers in Gulu City saw an increase during the COVID-19 lockdown, which aimed to control the spread of the disease.
The study identified various reasons behind the involvement of married women in commercial sex work, including economic challenges brought about by the COVID-19 pandemic. This led to joblessness, financial hardships, loss of regular employment, favorable treatment of sex workers for relief aid, and the profitability of the business itself.
Additional contributing factors included boredom, broken relationships, experiences of sexual violence, long-distance partnerships, abusive partners, and lack of support from male companions.
These commercial sex workers discreetly engaged in their trade, often leaving their marital homes without their male partners’ knowledge, all in pursuit of financial gain. The respondents in the study ranged in age from 15 to 49 years, and a notable finding was their significant use of dual contraceptives.
Out of the 314 participants, 208 were found to consistently use condoms alongside another modern method of family planning. More than half were observed to use intrauterine devices, indicating a cautious approach to preventing unplanned pregnancies.
Despite responsible contraceptive practices, instances were noted where some female sex workers engaged in unprotected intercourse due to higher financial rewards from clients for condomless encounters. This practice, while financially beneficial, exposed them to higher risks of sexually transmitted infections and diseases (STIs and STDs).
One positive aspect was that 75% of these workers tested negative for HIV, and many followed preventive measures like antiretroviral therapy (ARV) to protect themselves from HIV transmission. However, the study also pointed out significant obstacles that hindered female commercial sex workers’ access to sexual and reproductive health services.
Key challenges included stigma, low self-esteem, and negative attitudes from healthcare professionals. Another study within the same research framework, presented by Anna Grace Auma of Lira University, highlighted a concerning trend of repeated teenage pregnancies among young girls.
The research revealed that some teenagers experienced up to three pregnancies at a young age, underscoring the seriousness of unwanted pregnancies and their subsequent health impacts, including abortions, maternal mortality, infections, and disabilities.
Auma also noted the limited uptake of vasectomy among men, attributing this to lack of awareness, misconceptions, cultural and religious beliefs, and societal influences. The symposium also unveiled additional findings, such as the utilization of family healthcare services among health workers, which stood at 70.6%.
Dr. Francis Pebalo Pebolo, the Head of the Research Organizing Committee, stated that the research initiative encompassed various aspects, including commercial sex work, post-abortion care, sexual and reproductive health, and family planning. Siyane Aniley (Ph.D.) from CIRHT stressed the organization’s mission to reduce maternal mortality through enhanced education for medical students and support for curriculum development within the health system.
She called for policymakers to collaborate in reducing maternal deaths while promoting education on healthy sexual and reproductive lives.
CIRHT’s support extended to the establishment of lecture production studios, simulation laboratories, and teleconferencing facilities in Lira and Gulu Universities through the allocation of 48 seed grants.