Skip to main content

Syndemic of factors that shape the early lives of women who enter into sex work: A qualitative methods study from Nairobi, Kenya.

Shah, P., Beattie, T.S., Kabuti, R., Liku, J., Kung'U, M., Babu, H., Jama, Z., The Maisha Fiti Study Champions, , Kaul, R., Weiss, H.A., Kyegombe, N., Medley, G.F., Devries, K., Gafos, M., Nyariki, E., Kimani, J. and Seeley, J., 2023. Syndemic of factors that shape the early lives of women who enter into sex work: A qualitative methods study from Nairobi, Kenya. BMJ Open, 13 (4), 1-9.

Full text available as:

Syndemic of factors that shape the early lives of women who enter into sex work a qualitative methods study from Nairobi, Ke.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.


DOI: 10.1136/bmjopen-2022-068886


Objective To explore the structural and social co-factors that shape the early lives of women who enter sex work in Nairobi, Kenya. Design Thematic analysis of qualitative data collected as part of the Maisha Fiti study among female sex workers (FSWs) in Nairobi. Participants and measures FSWs aged 18-45 years were randomly selected from seven Sex Workers Outreach Programme clinics in Nairobi and participated in baseline behavioural-biological surveys. Participants in this qualitative study were randomly selected from the Maisha Fiti study cohort and were interviewed between October 2019 and July 2020. Women described their lives from childhood, covering topics including sex work, violence and financial management. Results 48 out of 1003 Maisha Fiti participants participated in the in-depth qualitative interviews. FSWs described how physical and sexual violence, poverty and incomplete education in their childhood and adolescence intertwined with early pregnancy, marriage, intimate partner violence and relationship breakdown in their adolescence and early adulthood. The data analysis found clear syndemic relationships between these risk factors, particularly childhood violence, poverty and incomplete education and highlighted pathways leading to financial desperation and caring for dependents, and subsequent entry into sex work. Women perceived sex work as risky and most would prefer alternative work if possible, but it provided them with some financial independence and agency. Conclusions This is the first study in Kenya to qualitatively explore the early lives of sex workers from a syndemic perspective. This method identified the pivotal points of (1) leaving school early due to poverty or pregnancy, (2) breakdown of early intimate relationships and (3) women caring for dependents on their own. Complex, multi-component structural interventions before these points could help increase school retention, reduce teenage pregnancy, tackle violence, support young mothers and reduce entry into sex work and the risk that it entails by expanding livelihood options.

Item Type:Article
Uncontrolled Keywords:EPIDEMIOLOGY;PUBLIC HEALTH;QUALITATIVE RESEARCH;Adolescent;Female;Humans;Adult;Child;Sex Work;Sex Workers;Kenya;Syndemic;Sexual Behavior;Intimate Partner Violence;HIV Infections
Group:Faculty of Health & Social Sciences
ID Code:40065
Deposited By: Symplectic RT2
Deposited On:27 Jun 2024 14:51
Last Modified:27 Jun 2024 14:51


Downloads per month over past year

More statistics for this item...
Repository Staff Only -