Undergraduate Honors Thesis

“Who Cares about Us–We are Just Women of the Street”–Combating HIV Transmission and Gender Disempowerment among Female Sex Workers in Salvador, Brazil (in progress)
Authors: Rachel Safeek, Sherman James, Ph.D
Duke University 
ABSTRACT

BACKGROUND: While Brazil is lauded for its exemplary HIV prevention model, the majority of HIV prevention programs promote safe sex through education, ignoring the realities of gender disempowerement and inequality, which increase the susceptibility of female sex workers (FSWs) to instances of violence and disease. This paper analyzes factors associated with gender disempowerment and lack of condom use among FSWs in Salvador (Bahia), Brazil who engage in heterosexual interactions with male clients. An understanding of the sources of gender disempowerment is key to developing culturally-appropriate and effective policy interventions.

METHODS: Over a three-month period, formal interviews were conducted with sixteen female sex workers. Focus group discussions were conducted with 35 female sex workers at Projeto Força Feminina. The latter is an organization located in Pelourinho, the Historic District of Salvador, that works with FSWs to promote safe sexual practices and combat gender-based violence. Three life histories were also conducted with three of the sex workers. Additionally, Dr. Edivania Landim, the former head of the HIV/AIDS program of Bahia was also interviewed.

RESULTS: Interviews and focus groups revealed that economic vulnerability (financial instability), drug use, and instances of gender-based violence (structural violence) and rape/sexual assault from police and clients disempower FSWs, increasing their susceptibility to the transmission of disease. In each case of disempowerment, the factors contributing to women’s decision to engage in intercourse without condoms or other types of risky or unsafe sex were influenced by their inability to defend themselves as women and as FSWs, a social group of women isolated on the bottom rung of Brazil’s social and economic ladder. The respondents were clear that their gender was a definite factor in the many difficulties they faced.

DISCUSSION: Increased emphasis should be placed upon female-specific forms of protection, e.g. female condoms, microbicides. Unionization among sex workers is necessary to gain political acknowledgement of sex worker rights through legalization of the profession.

KEY TERMS: HIV/AIDS, Female Sex Workers (Profissionais Do Sexo), Race, Economic Vulnerability, Disempowerment, Gender-Based Violence, Structural Violence, Health Disparities, Human Rights, Salvador, Brazil

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