HIV STIGMA AMONG
COMMERCIAL SEX WORKERS IN
3rd NOPE Conference at KICC Nairobi – Kenya
18th June to 20th June 2008
Presented by: Elizabeth Akinyi
Who is a sex worker?
• A sex worker is a person [male or female] who earns
money by providing sexual services. The term is
sometimes used as a synonym or euphemism for
prostitution, but most scholars define it to include all
individuals who perform sexual or sexually oriented
activities in the sex industry, such as strippers, erotic
massage therapists, pornography actors and actresses,
live sex shows, webcam shows, and phone sex
operators (Weitzer 2000).
What is stigma?
• Goffman² defines stigma in general as an undesirable or
discrediting attitude individual possesses, thus reducing
that individual’s status in the eyes of society and can
result from a particular characteristic, such as physical
deformity or it can be negative attitudes towards the
behaviour of a group, such as homosexuals or
commercial sex workers, IDUs, HIV positive people etc.
• Stigma may also be described as a label which
associates a person to a set of unwanted characteristics
that form a stereotype.
What is stigma cont!
• In sociological theory, a stigma is an attribute,
behavior, or reputation which is socially
discrediting in a particular way: it causes an
individual to be mentally classified by others in
an undesirable, rejected stereotype rather than
in an accepted, normal one.
• Erving Goffman, noted sociologist, defined
Stigma as a special kind of gap between virtual
social identity and actual social identity:
Why do people manifest stigma
towards sex workers?
• Traditionally, sex is only acceptable within marriage or at least
within a significant relationship [Goffman, 1968; Pheterson, 1998]
• Selling sex is thus seen as abnormal and therefore morally
wrong and sex workers as a group are stigmatized [Alexander,
• Myths and stereotypes that exist about sex workers are that
they are dirty/filthy and spread disease.
• It is assumed that they come from dysfunctional families.
• Blamed for social ills in the society e.g.. divorce cases in
Why stigma on sex workers cont.
• Stigma does not only apply to sex workers
and is often attached to any woman that is
sexually assertive or seen as impure.
• Stigma aims to silence and degrade those
that it targets, emphasizing their “shameful
Effects of stigma on sex workers.
• Most sex workers lack self esteem due to
the perception they have on themselves
as a result of internalizing stigma people
manifest towards them.
• Feeling of guilt, shame, despair and self
judgment leading to psychological
• Resolving into abusing drugs to run away
Effects of stigma on sex workers cont.
• The stigma that sex workers face can make it hard for
them to access health, legal, and social services. They
may either be afraid to seek out these services for fear of
discrimination, or physically blocked from accessing
• Barrier to meaningful social interactions with persons
who are not sex workers.
• Distanced from other family members including children.
Effects of stigma to the community
• Revenge as a result of stigma may lead to
violence in the family and community at large.
• Withdrawal from active participation in nation
building such as joining other social groupings in
the community and instead tend to have their
own social groupings and therefore denied a
chance of interaction with other members of the
Effects of stigma to the community cont.
• stigma "is among the many barriers that
discourage people from seeking
treatment" for their condition.
• Families may blame, neglect, or drive
away sick relatives in an effort to hide their
links to the epidemic which may be
perceived to have happened as a
consequence of “sinful, reckless, or
How can we reduce stigma on sex workers?
• APHIA 11 Coast is already involved in
stigma reduction campaigns and this is
done through implementing partners
focusing on sex workers such as
SOLWODI, ICRH and Voi youth forum,
with the support from USAID.
Stigma reduction cont.
• In the APHIA 11 programme, Sex workers are viewed as partners
and this raises their self esteem.
• They are directly involved in dissemination of anti-stigma messages
in the community especially on HIV/AIDs after being trained as peer
• They are also involved in HIV prevention campaigns and therefore
encouraged to look after their health and to access services that
could help them and their peers. Such services include; referals to
health facilities for ; VCT services, Family planning, Comprehensive
Care, T.B Check ups and treatment , as well as Home based care.
Stigma reduction cont.
• They are organized into support groups, and this
provides a forum for group therapy sessions and
generally sharing ideas.
• Peer counseling sessions are carried out by the
• They organize and actively participate in
• Forums involving sex workers and their family
members especially their children are facilitated.
Stigma reduction cont.
Interventions for stigma reduction are linked
with existing models for promoting the
recovery of persons.
Community outreaches organized by peer
educators in collaboration with other partners
Community outreaches organized by peer educators
• Support groups for PLWHAs have been formed and the number of
members keep on increasing.
• Community members have been reached with stigma reduction
• There is an increased number of sex workers going for VCT
• Sex workers being reconciled with their family members especially
children who have lost hope and could not cope with the situation.
• Increased number of sex workers seeking alternative means of
earning income other than sex work.
• Community members seeking support from the peer educators
especially referrals to health facilities
• We should all join hands to fight all sorts of
stigma in the community.
• Sex workers should be empowered to be
able to deal with issues that affect their
lives so that they can take the lead in
implementation of programmes such as
HIV/AIDs prevention and gender based
violence among others.
Do you know ! !
In the community, we are are seen as
dirty/filthy, good for nothing, husband
snatchers, people who spread sexually
transmitted infections etc.
Our services are highly on demand
Look beneath the surface
IT COULD BE YOUR ;