Human rights abuses and collective resilience among sex workers in four African countries: a qualitative study

BACKGROUND Sex work is a criminal offence, virtually throughout Africa. This criminalisation and the intense stigma attached to the profession shapes interactions between sex workers and their clients, family, fellow community members, and societal structures such as the police and social services. METHODS We explore the impact of violence and related human rights abuses on the lives of sex workers, and how they have responded to these conditions, as individuals and within small collectives. These analyses are based on data from 55 in-depth interviews and 12 focus group discussions with female, male and transgender sex workers in Kenya, South Africa, Uganda and Zimbabwe. Data were collected by sex worker outreach workers trained to conduct qualitative research among their peers. RESULTS In describing their experiences of unlawful arrests and detention, violence, extortion, vilification and exclusions, participants present a picture of profound exploitation and repeated human rights violations. This situation has had an extreme impact on the physical, mental and social wellbeing of this population. Overall, the article details the multiple effects of sex work criminalisation on the everyday lives of sex workers and on their social interactions and relationships. Underlying their stories, however, are narratives of resilience and resistance. Sex workers in our study draw on their own individual survival strategies and informal forms of support and very occasionally opt to seek recourse through formal channels. They generally recognize the benefits of unified actions in assisting them to counter risks in their environment and mobilise against human rights violations, but note how the fluctuant and stigmatised nature of their profession often undermines collective action. CONCLUSIONS While criminal laws urgently need reform, supporting sex work self-organisation and community-building are key interim strategies for safeguarding sex workers' human rights and improving health outcomes in these communities. If developed at sufficient scale and intensity, sex work organisations could play a critical role in reducing the present harms caused by criminalisation and stigma.