MAPPING TRANSACTIONAL SEX ON THE TRANS-AFRICA HIGHWAY
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Transcript of MAPPING TRANSACTIONAL SEX ON THE TRANS-AFRICA HIGHWAY
MAPPING TRANSACTIONAL SEX ON THE TRANS-AFRICA
HIGHWAY
Alan Ferguson1
Chester Morris2
1 Constella-Futures and University of Manitoba
2 University of Manitoba
Vulnerable people and vulnerable places
• Even in generalized epidemics, vulnerable groups disproportionately affected
• Where epidemic has peaked, re-concentration of infection in vulnerable groups
• Increasing evidence of locations that make people vulnerable to HIV
OBJECTIVES
• Measure volume and characteristics of highway-based transactional sex on section of Trans-Africa highway
– Identification of ’Hot Spots’– Risk-avoidance practices and un-met
needs– Client characteristics– Use of GIS in visualization and planning
METHODS
1. GIS
GPS mapping of stopovers
between Mombasa and
Kampala
Mapping of aggregate
data at national /
regional level
METHODS
2. Sex Worker Diaries (n=578)
• Completed for 28 consecutive days
• Permit calculation of:– No. partners, liaisons, sexual acts– Condom use– Occupation of client– Sex during menses– Mobility
METHODS
• Truckers FGDs (6)
• Truckers surveys (4)
• Sex Worker FGDs (22)
• Truck Census (all stopovers)
• Bar census / survey (1,007)
Basic results
No. of stopovers mapped 47
Mean No. of trucks parked overnight 3,066
Estimated No. of FSWs c.8,000
Total No. bars / lodgings mapped 1,007
Average weekly No. of crates of beer sold 12,046
No. bars / lodges selling / distributing condoms 601
No. bars / lodges having condom dispensers 181
Weekly no. of condoms sold / distributed in bars / lodges
82,324
Stopover points
Mean nos. overnight trucks
Mean no. trucks / FSW estimates
Truck and sex worker volumes: Uganda sector
Malaba
Sega
Busia
TCI
Naluwerere
Idudi
Mbikko
Lugazi
Kampala (Mbuya)
3065
75
500
100
100
750
1400
0 40 8020 Kilometers
Busia / Malaba - Kampala
Example of thematic map of single hot spot
Mean levels of transactional sex
13.3
24.4
52.9
0
10
20
30
40
50
60
Mean
Different clients per month
Liaisons per month
Sexual acts per month
Variations in mean monthly # sexual acts
No. of sexual acts
192
145
134
106
96
90
84
78
72
66
60
54
48
42
36
30
24
18
12
3
% F
SW
s
3.0
2.5
2.0
1.5
1.0
.5
0.0
Transactional sex by type of partner
81.6
18.4
51.948.1 50.749.3
0102030405060708090
% all clients % allliaisons
% all sexualacts
Casual Regular
Condom use per liaison by type of client
89.9
64.5
77.7
50
55
60
65
70
75
80
85
90
%
Casual Regular All
Client occupations
21.0%
1.1%
3.9%
6.4%
11.0%
2.4%
2.2%
7.4%
14.5%
30.2%
Others
Soldier
Health Worker
Teacher
Business / sales
Bar/Lodging worker
Artisan
Police
Other driver
Trucker
HIV Transmission
• Using AVERT model, estimated that 3,200 – 4,200 new infections per annum from transactional sex on highway
• Raising condom use to 90% would avert almost 2/3 of these new infections
CONCLUSIONS
• High levels of highway-based transactional sex in E. Africa
• Despite high levels of condom use, HIV transmission significant
• Client base much wider than expected suggesting a ‘vulnerable places’ approach to programming
• Both FSWs and truckers socially marginalized
CONCLUSIONS - Methodology
• GIS proved to be effective in visualization and advocacy
• Diaries are flexible and efficient means of generating data where recall and social desirability biases are present
THANKS TO