Effects of traumatic events on sex workers’ mental health and suicide intentions in Burkina Faso: a trauma-informed approach
Charles W. Cange A B D , Andrea L. Wirtz A , Odette Ky-Zerbo C , Marcel Lougue C , Seni Kouanda C and Stefan Baral A
+ Author Affiliations
- Author Affiliations
A Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
B Department of Health Sciences, Lehman College, The City University of New York, 250 Bedford Park Boulevard, New York, NY 10468, USA.
C Program d’Appui au Monde Associatif et Communautaire, 11 BP 1023 CMS Ouagadougou, Burkina Faso.
D Corresponding author. Email: cange@uw.edu
Sexual Health 16(4) 348-357 https://doi.org/10.1071/SH17213
Submitted: 1 March 2018 Accepted: 12 March 2019 Published: 12 July 2019
Abstract
Background: Data from other settings suggest that female sex workers (FSWs) are regularly exposed to violence and risks of psychological and physical trauma, although less is known about the effects of this violence. The objective of this study was to understand the experiences of violence and relationships with mental health symptomatology among FSWs. Methods: A mixed-methods design was used to explore the contexts and social perceptions of violence and mental health effects among FSW in Burkina Faso in 2013. Results: In all, 696 FSWs were recruited via respondent-driven sampling and enrolled in the study in Ouagadougou and Bobo-Dioulasso, Burkina Faso. Seventy participants were also recruited into qualitative research. Nearly two-thirds of quantitative respondents (61.7%) reported experiencing lifetime physical violence, of whom 77.4% reported experiencing violence after initiating sex work. Further, 40.9% of participants reported forced non-consensual sex, most of which occurred after they had started sex work (73.0%). In some cases, the male perpetrator used physical force to force non-consensual sex. Forced non-consensual sex was often without condoms. Among quantitative participants, 41.8% reported ever having feelings of depression; there was also a high prevalence of suicide ideation in this group. Qualitative participants also described feelings of depression, alienation, and suicide ideation. Some qualitative participants described using protective methods to avoid violence and to promote social protection among FSWs. Conclusions: The findings suggest that stigma and physical and sexual abuse are prevalent among FSWs. Within this context of sex work, lifetime experiences of physical and sexual violence were highly correlated with self-reported mental health symptoms.
Additional keywords: HIV/AIDS, mixed methods, trauma, violence.
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