Experiences of gender-based violence among female sex workers, men who have sex with men, and transgender women in Latin America and the Caribbean: a qualitative study to inform HIV programming
Open Access
- 5 March 2019
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC International Health and Human Rights
- Vol. 19 (1), 1-14
- https://doi.org/10.1186/s12914-019-0187-5
Abstract
Female sex workers, MSM, and transgender women—collectively referred to as key populations (KPs)—are disproportionately affected by gender-based violence (GBV) and HIV, yet little is known about the violence they face, its gender-based origins, and responses to GBV. The purpose of this study was to understand the nature and consequences of GBV experienced, to inform HIV policies and programming and to help protect KPs’ human rights. Using a participatory approach, FSWs, MSM, and transgender women in Barbados, El Salvador, Trinidad and Tobago, and Haiti conducted 278 structured interviews with peers to understand their experiences of and responses to GBV. Responses to open-ended questions were coded in NVivo and analyzed using an applied thematic analysis. Nearly all participants experienced some form of GBV. Emotional and economic GBV were the most commonly reported but approximately three-quarters of participants reported sexual and physical GBV and other human rights violations. The most common settings for GBV were at home, locations where sex work took place such as brothels, bars and on the street; public spaces such as parks, streets and public transport, health care centers, police stations and—for transgender women and MSM—religious settings and schools. The most common perpetrators of violence included: family, friends, peers and neighbors, strangers, intimate partners, sex work clients and other sex workers, health care workers, police, religious leaders and teachers. Consequences included emotional, physical, and sexual trauma; lack of access to legal, health, and other social services; and loss of income, employment, housing, and educational opportunities. Though many participants disclosed experiences of GBV to friends, colleagues and family, they rarely sought services following violence. Furthermore, less than a quarter of participants believed that GBV put them at risk of HIV. Our study found that across the four study countries, FSWs, MSM, and transgender women experienced GBV from state and non-state actors throughout their lives, and much of this violence was directly connected to rigid and harmful gender norms. Through coordinated interventions that address both HIV and GBV, this region has the opportunity to reduce the national burden of HIV while also promoting key populations’ human rights.Keywords
Funding Information
- USAID (Cooperative Agreement No. AID-OAA-A-14-00045)
- UNAIDS Unified Budget, Results and Accountability Framework
This publication has 42 references indexed in Scilit:
- “You are wasting our drugs”: health service barriers to HIV treatment for sex workers in ZimbabweBMC Public Health, 2013
- Estimating the Impact of Reducing Violence Against Female Sex Workers on HIV Epidemics in Kenya and Ukraine: A Policy Modeling ExerciseAmerican Journal of Reproductive Immunology, 2013
- Gender‐Based Violence and HIV: Reviewing the Evidence for Links and Causal Pathways in the General Population and High‐risk GroupsAmerican Journal of Reproductive Immunology, 2012
- Intimate Partner Violence: A Predictor of Worse HIV Outcomes and Engagement in CareAIDS Patient Care and STDs, 2012
- Victimization Experiences of Lesbian, Gay, and Bisexual Individuals: A Meta-AnalysisThe Journal of Sex Research, 2012
- A Meta-Analysis of Disparities in Childhood Sexual Abuse, Parental Physical Abuse, and Peer Victimization Among Sexual Minority and Sexual Nonminority IndividualsAmerican Journal of Public Health, 2011
- Correlates of Forced Sex Among Populations of Men Who Have Sex with Men in ThailandArchives of Sexual Behavior, 2009
- HIV Prevalence, Risks for HIV Infection, and Human Rights among Men Who Have Sex with Men (MSM) in Malawi, Namibia, and BotswanaPLOS ONE, 2009
- Attempted Suicide Among Transgender PersonsJournal of Homosexuality, 2006
- How Many Interviews Are Enough?Field Methods, 2006