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All violence questions were dichotomized into no violence versus some violence. Sex was usually sold within taverns and hostels Google Scholar Tabet, P.

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Anarfi, J. Appiah, and K. Health Transition Review Supplement to Volume 7 : — Bagarukayo, A. Entebbe: Amref. Barker, J. Battle, G. Cummings, and K. Human Organization 57 3 : Prostitutes Soweto Beidleman, T. Bloomington: Indiana University Press. Bryant, A. Pretoria: CIAC. Dale, D. Gwero, Zimbabwe: Mambo Press. Dinnan, C. In Female and Prostitutes Soweto in West Africa.

Oppong, ed. London: George Allen and Unwin. Doke, C. Malcolm, J. Prostitutes Soweto, and B. Johannesburg: Witwatersrand University Press. Donham, D. Cultural Anthropology 13 1 Prostitutes Soweto 3— Epprecht, M. Journal of Southern African Studies 24 4 : — Erlank, N.

Foucault, M. New York: Vintage Books. Gluckman, M. In African Systems of Kinship and Marriage.

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Radcliffe-Brown and D. Forde, eds. New York: Oxford. Halpeny, P. Parkin, ed. Oxford: Oxford. Hulley, S. Newman, and S. In Designing Clinical Research 2nd edn. Hulley et al. New York: Lippincott, Williams and Wilkins.

Jacobs, S. Afshar, ed. London: MacMillan. Jochelson, K. Mothibeli, and J. International Journal of Health Services 21 Prostitutes Soweto : Prostitutes Soweto Johnson, C. Goldstein and J. Manlowe, eds, pp. Kaijage, F. Karanja, W. Prostitutes Soweto Transformations of African Marriage.

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Park and D. Nyamwaya, eds. Manchester: Manchester University Press. Laketch, D. Prostitutes Soweto, D. Moodie, T. Los Angeles: University of California Press. Morris, A. Johannesburg: University of Witwatersrand Prostitutes Soweto. Mugambi, J. Nairobi: Longman Kenya. Nelson, N. In The Cultural Construction of Sexuality. Caplan, ed.

Meet the illegal sex workers on SA's dark streets and the people who help them

London: Tavistock. Ogden, J. In Postcolonial Identities in Africa. Werbner and Ranger, eds. London: Zed Books. Pittin, R. Sansom, B. Prostitutes Soweto and J. Comaroff, eds. Johannesburg: Juta.

Schapera, I. Schapera, ed. London: Routledge. Chicago: Northwestern University Press. Schmidt, E. Portsmouth: Heinemann. Schoepf, B. Herdt and S. Lindenbaum, eds, pp. London: Sage. Seidel, G. Discourses of Control and Exclusion. Reasons for sex work included: supplementing family income Sex was usually sold within taverns and hostels Vaginal sex was the most popular service procured by clients Overall, anal sex was sold by Lubricant use was reported by Hiding menstrual bleeding was practiced by Women who had not completed secondary school were more likely to be HIV-infected than those who had completed their schooling AOR 2.

Violence was non-significant in either model. Our data also highlights the high burden of violence borne by this population. Structural factors, including the lack of completed education, and migrancy were strongly associated with HIV. Age was also a an associated factor. Contrary to expectations, inconsistent condom use and binge drinking were not significantly associated with HIV status. Our findings add to a growing body of evidence highlighting that many FSWs in South Africa have a substantially higher burden of disease than the pooled prevalence of The findings suggest that FSWs in Soweto have an HIV prevalence substantially higher than the South African Prostitutes Soweto average, and of women aged Prostitutes Soweto years and older [ Prostitutes Soweto ].

Prevalence among FSWs in Soweto is also higher than previously recorded among women who have engaged in transactional sex in the township The Johannesburg study included a large inner-city Prostitutes Soweto population In comparison, only 16 FSWs in our study reported having immigrated from another country.

This may have been an aggravating factor Prostitutes Soweto the Prostitutes Soweto prevalence rates reported for Johannesburg, given that Despite the few cross-border migrants, our study confirms the need for interventions geared towards migrant SWs.

It further provides evidence of the need for structural level changes to laws and policies which perpetuate HIV vulnerability among FSWs [ 1 ]. South Africa has a checkered socio-political history, which has Prostitutes Soweto to poor educational outcomes for many women [ 4458 Prostitutes Soweto. Poor educational outcomes [ 4458 ] have been found to fuel an informal sex-for-money economy [ 144 ], which increases the likelihood of HIV.

South Africa has an unemployment rate of In our view, the overall low levels of education found in our study contribute in multiple ways to increased vulnerability Prostitutes Soweto HIV and economic marginalization. Our findings highlight the vulnerability of women over 25 years, and the substantial burden of disease among women over 30 years, two thirds of whom were HIV-infected. By comparison, HIV prevalence in Johannesburg was previously found to peak Prostitutes Soweto sex workers aged 16—24 years [ 5 ].

However, more than twice as many women reported sexual assault in our study as the number of assaults reported in the SAHMS Our prevalence of IPV is almost double that reported by women in the general population in Gauteng This study adds to a growing body of literature emphasizing the high levels of violence in South Africa and, in particular, those Prostitutes Soweto which SWs are exposed [ 1591421 — 232943 ].

Despite violence having reached epidemic proportions, South Africa has no national strategy to prevent violence against women. Correct and consistent condom use in the past month was not associated with HIV-infection in this study. While consistent condom use is effective in preventing HIV infection [ 962 ], it is unlikely that these FSWs became infected within this timeframe.

This null finding may indicate that FSWs are less likely to Prostitutes Soweto themselves once they discover an HIV-positive status. However, future research is required to elaborate more substantially on this possible explanation for poor condom use.

Our findings suggest that condom use at last sex may Prostitutes Soweto both an inflated and inadequate measure of consistent condom use. Shai et Prostitutes Soweto 63 ] highlight the importance of multiple measures of condom use to develop an adequate understanding of consistency over time. While recent trends have indicated that SWs consistently use condoms with Prostitutes Soweto clients [ 530 ], our findings suggest that a new measure of condom consistency is required. Prostitutes Soweto, the extremely low correct and consistent condom use reported in the Soweto environment is alarming, particularly given the mass promotion of condoms as a safe sex mechanism.

In this environment, usage may be Prostitutes Soweto by other factors Prostitutes Soweto as exposure to violence [ 2332 ], which has been reported to be high across the township [ 64 ]. Further research is required to understand mechanisms inhibiting the uptake of consistent condom use.

Approximately Prostitutes Soweto quarters of respondents had not told their partners that they engaged in sex work. Three quarters of those who had disclosed their profession were HIV-infected, more than half of whom reported condom use with their IP, possibly to protect him. Thus, knowledge Prostitutes Soweto her vocation may be mediating the relationship between other partner related factors and HIV vulnerability.

Prostitutes Soweto, Prostitutes in Soweto, Gauteng

This requires further Prostitutes Soweto to understand what partner factors relating to knowing that sex is sold, play a role in HIV vulnerability. This study describes a previously undocumented subset of FSWs who are based within Soweto, an urban African township on the outskirts of Johannesburg, Gauteng. Contrary to former accounts in the literature [ 9 — 11 ], FSWs in Soweto work largely in taverns or informal drinking establishments, and hostels.

While transactional-sex relationships in Soweto have been described previously [ 1314 ], our study highlights the impoverished nature of FSWs in Soweto, many Prostitutes Soweto whom enter the sex work industry as a means of survival. Dry sex or douching was bivariably associated with HIV, and may indicate the increased vaginal cleaning practices associated with more common vaginal infections for HIV-positive women[ 38 ].

The use of lubricant and the practice of hiding menstrual blood by inserting an object into the vagina have not been well documented in the literature. Hiding menstrual blood has Prostitutes Soweto anecdotally documented by local SW organizations.

The practice involves the insertion of objects Prostitutes Soweto as a kitchen sponge, cotton wool, a cloth, or tampon into the vaginal Prostitutes Soweto to prevent blood from showing during and after the Prostitutes Soweto of sexual services.

Violence was non-significant in either model.

In a sub-analysis, hiding menstrual blood was found to be associated Prostitutes Soweto with reporting recent STI symptoms and client violence analysis not shown. This suggests that it is vital that SW-specific practices need to be better documented and understood to ensure that interventions can be developed which are both appropriate to the FSW community and target their vulnerability to HIV.

Our study had several limitations including insufficient Prostitutes Soweto on the temporal sequencing of HIV seroconversion and associated factors such as Prostitutes Soweto, entry into sex work, condom use and alcohol consumption. Implicit in the analysis is the assumption that HIV seroconversion followed these associated factors, but we are unable to confirm that this is the case.

Our analysis assumed that recent sexual behavior is indicative of past sexual behaviors, Prostitutes Soweto caution should be taken in interpreting these results.

Some variation was observed between adjusted and unadjusted bivariate analysis in the RDS analysis; understanding of the use of RDS weights in multivariate analysis is limited [ 6566 ]. However, the difference between adjusted and unadjusted analyses suggests that when used in conjunction with sensitivity tests, RDS data provide an Prostitutes Soweto model for use in weighted multivariate logistic analyses.

However, care must be taken in screening potential participants to ensure that they do sell sex. Importantly, it is vital that more complex analyses are conducted on SW data to unpack the complex interplay of causal mechanisms leading to their vulnerability to HIV, which are likely to be non-linear in nature. Our findings highlight Prostitutes Soweto vulnerability of FSWs to the disease, which is strongly driven by a combination of structural, biological and behavioral determinants.

Soweto represents a microcosm of South Africa in terms of the epidemic of violence and HIV plaguing society, and which Prostitutes Soweto often beyond the control of individuals. The South Prostitutes Soweto government needs to urgently address structural factors impacting entry into and practices used in sex work.

These factors often function Prostitutes Soweto highly complex ways, and require innovative and alternative thinking beyond the scope of traditional HIV prevention and treatment. This study also highlights the need for improved access to ART services as both a treatment and prevention strategy.

At the same time, our findings suggest that Prostitutes Soweto may be more immediate concerns facing Prostitutes Soweto which require more urgent Prostitutes Soweto.

In line with Shannon et al [ Prostitutes Soweto67 ], these individual and structural level factors function to drive the epidemic and require inclusion within SW HIV programs. In the case of SWs, capacity development in the form of adult education, coping skills and mindfulness practices may prove valuable tools in the HIV Prostitutes Soweto. Furthermore, in comparison to the SAHMS findings [ 5 ], these findings highlight the critical value of profiling a given population to ensure that interventions are contextually tailored.

Such action will ensure that access to treatment and prevention through rights-based services is effectively implemented in South Africa in line with the South Prostitutes Soweto National Sex Worker HIV Plan — [ 3 ]. In addition, funding Prostitutes Soweto received through The Albert Wessels Trust. National Center for Biotechnology InformationU.

PLoS One. Published online Oct 5. Glenda E. William Cameron, Editor. Author information Article notes Copyright and License information Disclaimer. Competing Interests: The authors have declared that no competing interests exist. Received Feb 7; Prostitutes Soweto Aug This is an Prostitutes Soweto access article distributed under the terms of the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

This article has been cited by other articles in PMC. S2 Text: Questionnaire English.

Donham, D.

S3 Text: Questionnaire All Languages. Method This cross-sectional study formed part of a larger project aimed at understanding the complex interplay of factors associated with Prostitutes Soweto infection for FSWs in Soweto. Open in a separate window. Prostitutes Soweto 1. Recruitment tree indicating initial seeds recruited 0 and all their subsequent recruits, known as recruitment chains.

Fig 2.

Study flow diagram showing successful enrollment as well as the number of coupons distributed during the study. Measures Coupon numbers were recorded and linked between seeds, recruiters and subsequent recruits Fig 1.

Significant items are in bold. Table 4 Logistic regression analysis of factors affecting HIV seropositive status of female sex workers in a South African township, with both weighted and unweighted multivariate analysis displayed.

PDF Click here for additional data Prostitutes Soweto. S2 Text Questionnaire English. S3 Text Questionnaire All Languages. Data Availability Prostitutes Soweto relevant data are included within the paper and its Supporting Information files.

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Wojcicki JM, Malala J. Social Science and Medicine. Stadler J, Delaney S. Prostitutes Soweto ' healthy Prostitutes Soweto the context of clinical services for sex workers in Hillbrow, South Africa.

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Leggett T. Society in Transition. More than just talk: the framing Prostitutes Soweto transactional sex and its Prostitutes Soweto for vulnerabilty to HIV in Lesotho, Madagascar and South Africa.

Globalization and Health. Wojcicki JM. Commercial sex work or Ukuphanda? Sex-for-money exchange in Soweto and Hammanskraal area, South Africa.

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Culture, Medicine and Psychiatry. Soc Sci Med. Socio-demographic characteristics and behavioral risk factors of female sex workers in sub-saharan Africa: a systematic review. AIDS Behav. Prevalence and patterns of gender-based violence and Prostitutes Soweto among women attending antenatal clinics in Soweto, South Africa. American Journal of Epidemiology. How sex work becomes an option: Experiences of female sex workers in Kerman, Iran. Sinha S. Hum Ecol ; 40 — Pretorius G, Bricker D.

Journal of Psychology in Africa. Rekart M. Sex-work harm reduction. The Lancet. Shannon K, Csete J. Gender-based violence, relationship power and risk of HIV infection in women attending antenatal clinics in South Prostitutes Soweto. Mmari K, Sabherwal S.

Journal Prostitutes Soweto Adolescent Health.

Age at menarche, schooling, and sexual debut in northern Malawi. South African national HIV prevalence, incidence,behaviour and communication survey A turning tide among teenagers? Health Systems Trust [Internet]. HIV prevention : Academic Press; Harcourt C, Donovan B. The many faces of sex work. Sexually Transmitted Infections.

Varga CA. Karim SS, Ramjee G. Anal sex and HIV transmission in women. Am J Public Health. Man-to-woman sexual transmission of HIV: longitudinal study of steady partners of infected men.

J Acquir Immune Defic Syndr. Prostitutes Soweto of female to male and male to female transmission of HIV in stable couples. Ramjee G, Daniels B. Distinguishing the temporal association between women's intravaginal practices and risk of human immunodeficiency virus infection: a prospective study of South African women.

Am J Epidemiol. Vaginal washing and increased risk of HIV-1 acquisition among African women: a year prospective study. Rosa ME, Tudg J. Journal of Family Theory and Review. Creighton D. Men and Masculinities. Medical Anthropology Quarterly. Hunter M. The Prostitutes Soweto political economiy of sex in South Africa: Prostitutes Soweto significance of unemployment and inequalities to the Prostitutes Soweto of the AIDS pandemic.

World Health Organisation. Module 4: Introduction to Respondent Driven Sampling. Heckathorn DD. Social Problems.

Sociological Methodology. Respondent driven sampling valid population Prostitutes Soweto from chain-referal samples Prostitutes Soweto hidden populations. Research electronic data capture REDCap —A metadata-driven methodology and workflow process for providing Prostitutes Soweto research informatics support.

J Biomed Inform. Asking young people about sexual and reproductive behaviours. Geneva, Switzerland: World Health Organization; Geneva: World Health Organisation,; Prostitutes Soweto Ithaca, NY Nattrass N, Seekings J. Race and economic inequality in South Africa today. Africa SS.

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The original audit scale scores were calculated using the three-item scale with the standard female cut-off at 3. All non-seed recruiters were asked to give the coupons only to randomly selected women they knew and who knew them, who, like themselves, sold sex in Soweto, and who were older than Eleven apartheid-era, formerly single-sex, ethnically segregated hostels house an estimated 40 residents.