Prevalence and factors associated with violence against women who exchange sex for money in Gulu City, Northern Uganda: a cross-sectional study

Article Authors: Winnie, K., Pebalo Francis, P., Ronald, O., Jerom, O., Jimmyy, O., Silvia, A., Simple, O., Michael, K., Grace, M., & Felix, B. (2025).

    • Abstract


    Background Gender-based violence (GBV) is a public health concern disproportionately affecting female sex workers (FSWs) globally. We investigated the prevalence and factors associated with GBV against women engaged in sex work in Gulu City, Uganda.

    Methods In this community-based study, we included FSWs purposely selected from hotspots within Gulu City, Uganda, between February and April 2023. Data on participants’ characteristics and history of GBV in the past 1 year prior to the interview were collected using a structured questionnaire. Bivariate logistic regression analyses were performed to identify the factors associated with GBV.

    Results Of the 314 participants, 222 (70.7%) reportedly experienced GBV in the past year, most frequently economic violence (66.9%, n=210), followed by verbal violence (41.4%, n=130), physical violence (27.7%, n=87) and sexual violence (27.4%, n=86). Factors associated with GBV were secondary education level (adjusted OR (AOR): 0.17, 95% CI 0.03 to 0.87, p=0.034), history of pregnancy (AOR: 3.41, 95% CI 1.05 to 11.04, p=0.041) and places of sex work at bars (AOR: 5.59, 95% CI 2.03 to 15.38, p=0.001), night clubs (AOR: 3.69, 95% CI 1.26 to 10.61, p=0.017) and client’s place (AOR: 3.62, 95% CI 1.21 to 10.86, p=0.022).

    Conclusion GBV against FSWs in Gulu City, Uganda, is unacceptably high. Therefore, there is an urgent need to address violence in sex work in Uganda and similar settings worldwide through multisectoral targeted interventions and creating safer working environments by the Ministry of Health and other concerned entities.

    Bibliographical metadata

    Journal BMJ Public Health
    Volume 3
    Issue No. 1
    DOI https://doi.org/10.1136/bmjph-2024-001486
    Links https://bmjpublichealth.bmj.com/content/3/2/e001486
    Related Faculties/Schools
    Affiliation

    1School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda

    2Department of Reproductive Health, Gulu University, Gulu, Uganda

    3School of Medicine, Makerere University, Kampala, Uganda

    4Department of Medical Microbiology and Immunology, Gulu University, Gulu, Uganda

    5Gulu University, Gulu, Uganda

    6The AIDS Support Organization, Kampala, Kampala, Uganda

    7The Institute of Clinical Trials and Methodology, University College London, London, UK

    8Clinical Directorate, Joint Clinical Research Center, Wakiso, Uganda

    9Department of Rural Development and Agri-Business, Gulu University, Gulu, Uganda