Triple jeopardy: Adolescent experiences of sex work and migration in Zimbabwe |
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| Affiliation: | 1. London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom;2. The Centre for Sexual Health and HIV AIDS Research, Zimbabwe;3. University College London, United Kingdom;1. Research Centre for Maori Health and Development, Massey University, Wellington, New Zealand;2. The Hepatitis Foundation of New Zealand, Whakatane, New Zealand;1. Association for Social Development, Islamabad, Pakistan;2. KNCV Tuberculosis Foundation, Islamabad, Pakistan;3. PHTB Consult, Tilburg, Netherlands;1. Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands;2. Julius Centre for Health Sciences & Primary Care, University Medical Centre Utrecht, The Netherlands;3. European Public Health Microbiology Training Program (EPIET/EUPHEM), European Centre for Disease Prevention and Control, Stockholm, Sweden;4. Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People''s Republic;5. Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Medicine, Churchill Hospital, University of Oxford, Oxford, England, UK;6. Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands;1. Division of Bacteriology, Chiba Prefectural Institute of Public Health, Chiba, Japan;2. Department of Infectious Disease, Kobe Institute of Health, Hyogo, Japan;3. Department of International Health, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan;4. Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata, Japan;1. Anaesthesiology and Critical Care, Sainte-Anne Military Teaching Hospital, 83800 Toulon, France;2. Healthcare Workers Ebola Treatment Unit, Conakry, Guinea;3. Anaesthesiology and Critical Care, Laveran Military Teaching Hospital, 13013 Marseille, France;4. Laboratory, Sainte-Anne Military Teaching Hospital, 83800 Toulon, France;1. Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA;2. Population Services International/Liberia, Gardner Street, Between 11th & 12th Streets, Sinkor, Monrovia, Liberia;3. Women and Health Initiative, Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA;4. Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Division of Adolescent and Young Adult Medicine, Boston Children''s Hospital, 677 Huntington Avenue, Boston, MA, 02115, USA |
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| Abstract: | Adolescence, migration and sex work are independent risk factors for HIV and other poor health outcomes. They are usually targeted separately with little consideration on how their intersection can enhance vulnerability. We interviewed ten women in Zimbabwe who experienced sex work and migration during adolescence, exploring implications for their health and for services to meet their needs. For most, mobility was routine throughout childhood due to family instability and political upheaval. The determinants of mobility, e.g. inability to pay school fees or desire for independence from difficult circumstances, also catalysed entry into sex work, which then led to further migration to maximise income. Respondents described their adolescence as a time of both vulnerability and opportunity, during which they developed survival skills. While these women did not fit neatly into separate risk profiles of “sex worker” “migrant” or “adolescent”, the overlap of these experiences shaped their health and access to services. To address the needs of marginalised populations we must understand the intersection of multiple risks, avoiding simplified assumptions about each category. |
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| Keywords: | Zimbabwe Adolescents Migration Sex work Sexual health |
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