Online Program

Motivation for alcohol use in the context of commercial sex work and its influence on sexual risk: A qualitative study in Ugandan fishing communities

Tuesday, November 3, 2015

Katelyn Sileo, MPH, Joint Doctoral Program in Global Health, Graduate School of Public Health, San Diego State University, San Diego, CA
Michael Kintu, Wakiso Integrated Rural Development Association, Entebbe, Uganda
Susan Kiene, PhD, MPH, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, San Diego, San Diego

In the fishing communities surrounding Lake Victoria, HIV prevalence is estimated to be as high as 28%, compared to 7.3% in the general Ugandan population. Commercial sex work and heavy alcohol use have been identified as major contributing factors to the elevated HIV risk, but little is known about the factors that influence alcohol use during sex, especially in the context of commercial sex work.


A total of 50 individuals (23 male, 27 female) participated in one of eight focus group discussions conducted in Gerenge, Uganda: one group of CSWs (n=6), two groups of fishermen (n=13), two groups of fishmongers (n=13), two groups of alcohol sellers (n=12), and one group of restaurant owners (n=6). Focus group data was analyzed using a content analysis approach.


The main motivation for alcohol use during sex and engaging in commerical sex among fishermen was for leisure. CSWs were motivated to use alcohol during sex to become more sexually forward with clients, to gain control over clients, and to cope with the stressors of their work. Alcohol use was said to increase the likelihood of unprotected sex through several pathways, including impaired judgment, reduced perceived vulnerability to HIV, and increased aggression from male clients.


These findings highlight the need to focus on alcohol reduction as a strategy toward HIV/AIDS prevention among Ugandan fishermen and CSWs. Interventions that alter sex-related alcohol outcome expectancies and teach alternative strategies to cope with stress among CSWs may be especially impactful.

Learning Areas:

Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Identify motivations for alcohol use in the context of commercial sex work among Ugandan fishermen and sex workers. Name several pathways in which alcohol use during sex may lead to increased HIV risk among Ugandan fishermen and sex workers. Design intervention strategies tailored to Ugandan fishermen and sex workers to reduce sexual risk taking.

Keyword(s): HIV/AIDS, Sex Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student in the SDSU/UCSD joint degree program (JDP) in Global Health and a NIDA pre-doctoral fellow studying HIV/AIDS and substance abuse. My main research interests are in HIV/AIDS and maternal and child health, with a specific interest in gender and substance abuse. I have supported several NIH and PEPFAR funded research projects assessing interventions to reduce HIV risk behaviors among high-risk populations in Uganda and elsewhere in sub-Saharan Africa.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.