“I expect to be abused and I have fear”

African Sex Worker Alliance, “’I expect to be abused and I have fear’: sex workers’ experiences of human rights violations and barriers to accessing healthcare in four African countries” (2011)


This report documents human rights violations experienced by female, male and transgender sex workers in four African countries (Kenya, Uganda, South Africa and Zimbabwe), and describes barriers they face to accessing health services.

Through cross-country comparison and documenting of sub-regional trends, the study moves beyond previous often-localised descriptions of violations against sex workers in Africa. The study also fills information gaps about violations in male and transgender sex workers in this setting.

Key findings from this study include:

  • Many participants were identified as foreign or internal migrants.
  • Sexual violence, perpetrated by police and related authorities, was common.
  • Men who sell sex to women reported less police harassment, but police abuse of other male sex workers was frequent, often marked by homophobia.
  • A range of people on the fringes of the sex industry take advantage of sex work criminalisation by extorting money or sex.
  • Clients, according to female sex workers, commonly ignored their wishes or the occurrence of pain.
  • Once a sex worker’s occupation became known, they were usually despised by family and community members.
  • Many reported being ostracised by religious institutions.
  • There was an understanding that the criminalisation of sex work renders sex workers largely powerless.
  • Female sex workers also called for improved access to pap smears and female condoms.
  • Sex workers described many instances of poor treatment once health providers became aware of their work.
  • Private services were described as higher quality and as places where they would be treated with dignity and their confidentiality protected.
  • Sex workers commonly chose not to disclose their occupation when interacting with health workers.
  • Sex workers in most sites reported difficulties in accessing condoms, resorting to using expired or used condoms, or stopping work while condom shortages lasted.
  • Participants emphasised the importance of local organisations dedicated to supporting sex workers and working alongside to advocate and seek legal redress to violations.

Full text available here.

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