KAMPALA, UGANDA – Nisha is a commercial sex worker in Kabalagala, a neighborhood outside Kampala, Uganda’s capital.
Nisha, whose last name is withheld to protect her safety, says sex work enables her to support herself without an education.
“I did not go far in school, and yet I have a good life from this,” she says.
She stays in the business of sex work because she says the returns are higher than other jobs. She charges her clients between 100,000 Ugandan shillings ($40) and 300,000 shillings ($110).
“Which job is going to give 200,000 shillings ($75) a night or slightly less?” she asks. “Do you expect me to go and work as a waitress for 120,000 shillings ($45), 12 hours a day, six days a week?”
Nisha plans to engage in sex work until she makes enough money to construct a commercial rental building so that she can make a living in real estate.
“I will not stop until I build a multiple-storied commercial structure in the city of Kampala,” she says.
She acknowledges that sex work can be risky.
“You have to study the client,” Nisha says. “The ones who are dressed nicely and act all educated are the ones who like bargaining and will usually gang-rape you.”
She says that in these scenarios, sex workers have little power, so they do their best to protect against HIV and other sexually transmitted diseases.
“What can you do?” she asks. “It is your business! You just pray that none of them is infected or you try and offer them condoms.”
Nisha sees a prospective client and abruptly walks away.
“God is the one who protects us!” she says as she sashays seductively toward him.
As a new study publicizes the high HIV-infection rate among female sex workers in Uganda, some local advocates urge the government to decriminalize sex work to increase their access to health care. But others insist that rehabilitation of sex workers is the better strategy. Officials say that the government plans to crack down on brothels, not decriminalize sex work. Meanwhile, the East African Community heads of state are considering a bill that would ensure care and protection to all citizens living with HIV and AIDS.
Uganda has one of the highest rates of HIV infections in the world among female sex workers, who account for 15.7 percent of infections in Uganda, according to a study published in 2012 in The Lancet Infectious Diseases, a medical journal. The four-year study, funded by the World Bank and the United Nations Population Fund, found that 37.2 percent of female sex workers in Uganda are HIV-positive, compared with 8.5 percent of women of reproductive age who are not sex workers.
“Considerations of the legal and policy environments in which sex workers operate and the important role of stigma, discrimination and violence targeting female sex workers globally will be required to reduce the disproportionate disease burden among these women,” wrote Dr. Stefan Baral of the Johns Hopkins Bloomberg School of Public Health, who led the study.
The Penal Code Act outlaws living on the earnings of prostitution in Uganda, penalizing it with seven years in prison.
Some local advocates say that decriminalizing sex work would be the best way to enable sex workers to access the services they need to prevent HIV infection and treat HIV and AIDS.
Juliet Katongole, director of Crested Crane Lighters, which advocates for the human rights of sex workers in Bwaise, a Kampala suburb, says there are many sex workers operating within Kampala.
“We work to improve the conditions and circumstances of their work and environment,” she says.
Katongole says that the criminalization of sex work hasn’t stopped the flourishing trade. Rather, it leaves sex workers more vulnerable to safety and health risks such as HIV and AIDS. Of the 70 registered members of Crested Crane Lighters, more than 30 are infected with HIV and AIDS.
The organization strives to help sex workers prevent HIV infection and transmission.
“We encourage them to always use condoms and go ahead to provide them with condoms,” Katongole says.
But Katongole says sex workers face challenges when negotiating safe sex with their multiple partners, who sometimes force them to have unprotected sex. She attributes this to a lack of institutional protection because of the criminalization of sex work.
“We supply condoms to the brothels around and the prostitutes themselves all the time,” she says. “But the brothel managers here in Bwaise report to us that they always find the unused condoms under the beds when they clean up.”
She ridicules men in Kampala who don’t think that they need to use condoms to prevent HIV transmission.
“They think HIV/AIDS shows on the skin,” she says.
She says society therefore shouldn’t blame sex workers for HIV transmission.
“How can you blame them for the infection, and yet the customer demanded unprotected sex when they offered condoms?” she asks.
She says that the government should decriminalize sex work in order to increase sex workers’ access to health care services to prevent and to treat HIV and AIDS.
“The government also needs to legalize the trade because it is not going to go away,” Katongole says.
But Dr. Stella Alamo Talisuna, the executive director of Reach Out Mbuya Parish HIV/AIDS Initiative, a community faith-based organization that provides support to people living with HIV and AIDS in urban areas, disagrees that legalizing sex work in Uganda would mitigate infections.
Instead, she promotes the rehabilitation of sex workers. Her organization is starting a new program that promotes both health and skills training among sex workers.
“If sex workers can find a viable alternative means of income, they will eventually get off the streets,” Talisuna says.
But Katongole says that rehabilitation is unrealistic.
“The issue of rehabilitation is very expensive and complicated,” she says.
She says it’s one’s choice to leave sex work, but no members of her organization have abandoned it so far.
“If one of them decides along the way to stop prostitution as a result of this, well and good,” she says. “But so far, there is none.”
Katongole says this is because sex work is lucrative here.
“The market for prostitution locally is huge and very productive,” she says.
She says that legalization will make sex work safer.
“When it is legalized, then most of the human rights abuses committed ... can be mitigated,” Katongole says.
But the Rev. Simon Lokodo, Uganda’s minister for ethics and integrity, said in a phone interview that the government would not legalize sex work and that it was still a crime punishable by law. He calls on sex workers to abandon the trade.
“They must return to their homes and communities and stop being commercial sex workers,” he says. “The choice of a person to sell their bodies for money cannot be considered a human right but a crime, punishable by law.”
He says his ministry is aware of the brothels in operation and warns proprietors of heavy police action.
“We are coming for them!” he says. “Actually, my office in conjunction with the police department is currently in a drive to round them up and arrest them.”
A police source at the Jinja Road Police Station, speaking on the condition of anonymity, highlighted the main informal red-light districts in Kampala.
“In the Kampala area alone, commercial sex operation areas include Kinawataka, Katwe, Kisenyi, Speke Road, Luwum Street, Kabalagala, Kansanga and Bwaise,” he says.
Lokodo denied knowledge of harassment by police or solicitors, as alleged by local sex workers.
“Until the sex workers present evidence of sexual harassment and torture by the police or their customers, I cannot do anything,” he says.
But the police officer says that he is aware of police brutality against sex workers.
“I am aware that my fellow policemen sometimes perpetrate crimes against these commercial sex workers, including demanding for sex in exchange for protection,” he says. “But evidencing and reporting these crimes is a challenge.”
At the same time, he says that some sex workers harass police, provoking arrests.
“These prostitutes make it very easy for us to arrest them also,” he says. “Most of them are alcohol and drug abusers who will even start to insult us on patrol when we are just passing by and throw objects at us. So we arrest them under the Criminal Procedure Code Act 1950, Chapter 116, as vagabonds and hooligans.”
Difficulty proving that someone is living off the proceeds of prostitution makes charges on other grounds more common. But the policeman adds that he doesn’t think sex work should be criminalized.
“I personally do not believe a prostitute has committed a crime,” he says, “and despite having been on the 999 patrol operation for many years, I have never arrested one.”
Katongole says that relations with police are better now than before. She says that bribes have replaced arrests and rapes.
Katongole says that developments in medical treatment have also improved the lives of HIV-positive sex workers.
“There is treatment nowadays,” she says, “and it is not as bad as it used to be when prostitutes would go into hiding when the sickness overcame them and returned when they got better.”
Crested Crane Lighters encourages its members to test for their status and to obtain treatment if needed, Katongole says. The organization also asks members to be open about their HIV statuses with each other because they may share the same clients.
“The same man demanding and paying for live sex … will demand the same from another infected prostitute tomorrow,” she says, “and the cycle continues.”
The East African Legislative Assembly, of which Uganda is a member, debated and passed the HIV and AIDS Prevention and Management Bill 2012 in April. The bill requires governments in East Africa to ensure that people living with or affected by HIV and AIDS receive support, care and treatment services, and protection from all forms of abuse and discrimination.
This means that commercial sex workers in Uganda will be institutionally protected, though they will still be excluded from most international aid. The bill now awaits approval by the East African Community heads of state before it can become an act.
