Violence across the Life Course and Implications for Intervention Design: Findings from the Maisha Fiti Study with Female Sex Workers in Nairobi, Kenya

Tara S. Beattie (), Rhoda Kabuti, Alicja Beksinska, Hellen Babu, Mary Kung’u, The Maisha Fiti Study Champions, Pooja Shah, Emily Nyariki, Chrispo Nyamweya, Monica Okumu, Anne Mahero, Pauline Ngurukiri, Zaina Jama, Erastus Irungu, Wendy Adhiambo, Peter Muthoga, Rupert Kaul, Janet Seeley, Helen A. Weiss and Joshua Kimani
Additional contact information
Tara S. Beattie: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
Rhoda Kabuti: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Alicja Beksinska: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
Hellen Babu: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Mary Kung’u: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
The Maisha Fiti Study Champions: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Pooja Shah: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
Emily Nyariki: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Chrispo Nyamweya: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Monica Okumu: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Anne Mahero: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Pauline Ngurukiri: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Zaina Jama: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Erastus Irungu: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Wendy Adhiambo: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Peter Muthoga: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya
Rupert Kaul: Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
Janet Seeley: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
Helen A. Weiss: MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
Joshua Kimani: Partners for Health and Development in Africa, Nairobi P.O. Box 3737-00506, Kenya

IJERPH, 2023, vol. 20, issue 11, 1-17

Abstract: We examined violence experiences among Female Sex Workers (FSWs) in Nairobi, Kenya, and how these relate to HIV risk using a life course perspective. Baseline behavioural–biological surveys were conducted with 1003 FSWs June-December 2019. Multivariable logistic regression models were used to estimate the adjusted odds ratio (AOR) and 95% confidence intervals (CI) for associations of life course factors with reported experience of physical or sexual violence in the past 6 months. We found substantial overlap between violence in childhood, and recent intimate and non-intimate partner violence in adulthood, with 86.9% reporting one or more types of violence and 18.7% reporting all three. Recent physical or sexual violence (64.9%) was independently associated with life course factors, including a high WHO Adverse Childhood Experiences (ACE) score (AOR = 7.92; 95% CI:4.93–12.74) and forced sexual debut (AOR = 1.97; 95% CI:1.18–3.29), as well as having an intimate partner (AOR = 1.67; 95% CI:1.25–2.23), not having an additional income to sex work (AOR = 1.54; 95% CI:1.15–2.05), having four or more dependents (AOR = 1.52; 95% CI:0.98–2.34), recent hunger (AOR = 1.39; 95% CI:1.01–1.92), police arrest in the past 6 months (AOR = 2.40; 95% CI:1.71–3.39), condomless last sex (AOR = 1.46; 95% CI:1.02–2.09), and harmful alcohol use (AOR = 3.34; 95% CI:1.74–6.42). Interventions that focus on violence prevention during childhood and adolescence should help prevent future adverse trajectories, including violence experience and HIV acquisition.

Keywords: violence; female sex workers; Kenya; HIV; adverse childhood experiences (ACEs) (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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