Martin Mbonye et al (2013): ‘It is like a tomato stall where someone can pick what he likes’: structure and practices of female sex work in Kampala, Uganda, BMC Public Health 2013, 13:741 doi:10.1186/1471-2458-13-741.
Effective interventions among female sex workers require a thorough knowledge of the
context of local sex industries. We explore the organisation of female sex work in a low
socio-economic setting in Kampala, Uganda.
We conducted a qualitative study with 101 participants selected from an epidemiological
cohort of 1027 women at high risk of HIV in Kampala. Repeat in-depth life history and work
practice interviews were conducted from March 2010 to June 2011. Context specific factors f female sex workers’ day-to-day lives were captured. Reported themes were identified and
Of the 101 women, 58 were active self-identified sex workers operating in different locations
within the area of study and nine had quit sex work. This paper focuses on these 67 women
who gave information about their involvement in sex work. The majority had not gone
beyond primary level of education and all had at least one child. Thirty one voluntarily
disclosed that they were HIV-positive. Common sex work locations were streets/roadsides,
bars and night clubs. Typically sex occurred in lodges near bars/night clubs, dark alleyways
or car parking lots. Overall, women experienced sex work-related challenges at their work
locations but these were more apparent in outdoor settings. These settings exposed women to
violence, visibility to police, a stigmatising public as well as competition for clients, while
bars provided some protection from these challenges. Older sex workers tended to prefer bars
while the younger ones were mostly based on the streets. Alcohol consumption was a feature
in all locations and women said it gave them courage and helped them to withstand the night
chill. Condom use was determined by clients’ willingness, a woman’s level of sobriety or
Sex work operates across a variety of locations in the study area in Kampala, with each
presenting different strategies and challenges for those operating there. Risky practices are
present in all locations although they are higher on the streets compared to other locations.
Location specific interventions are required to address the complex challenges in sex work