War-Related Abduction and History of Incarceration Linked to High Burden of HIV among Female Sex Workers in Conflict-Affected Northern Uganda.
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Date
2016-09-01
Journal Title
Journal ISSN
Volume Title
Publisher
Wolters Kluwer Health, Inc.
Abstract
Objective: Sex workers (SWs) in sub-Saharan Africa face a disproportionate HIV burden and growing concerns of severe human rights violations. Given the dearth of evidence on the burden and correlates of HIV among SWs in sub-Saharan Africa, particularly within conflict-affected settings, we examined the relationship between structural determinants (eg, war-related abduction, incarceration) and HIV infection among conflict-affected SWs in Northern Uganda.
Design: Cross-sectional community-based research study among female SWs in conflict-affected Gulu, Northern Uganda.
Results: Of 400 SWs, 135 (33.75%) were HIV seropositive; of whom one-third were new/previously undiagnosed HIV infections. In multivariable analysis, after adjusting for age of sex work entry and education, lifetime incarceration (adjusted odds ratio: 1.93, 95% confidence interval: 1.17 to −3.20) was independently associated with HIV seroprevalence, and history of wartime abduction (adjusted odds ratio: 1.62, 95% confidence interval: 1.00 to 2.63) was marginally associated (P = 0.051).
Conclusions:
This study documented a high rate of undiagnosed HIV infections and associations between war-related human rights violations, incarceration, and a heavy HIV burden among SWs in conflict-affected Northern Uganda. These findings highlight the serious harms of conflict and criminalization of marginalized women in sub-Saharan African contexts. SW-led interventions that address conflict experiences and policy shifts to promote a rights-based approach to HIV prevention and care remain critically needed.
Description
This study documented a high rate of undiagnosed HIV infections and associations between war-related human rights violations, incarceration, and a heavy HIV burden among SWs in conflict-affected Northern Uganda.
Keywords
Sex work, HIV, Conflict, Structural determinants, Humanitarian emergencies, Sub-Saharan Africa, Uganda
Citation
Goldenberg, Shira M., Muzaaya, Godfrey, Akello, Monica, Nguyen, Paul, Birungi, Josephine, and Shannon, Kate, 2016. War-Related Abduction and History of Incarceration Linked to High Burden of HIV among Female Sex Workers in Conflict-Affected Northern Uganda.