Female Sex Worker Mothers' Empowerment Strategies amid Social, Economic and HIV/AIDS Risks in Cameroon

Background: Studies have consistently demonstrated that Female Sex Worker (FSW) mothers are banding together to protect each other and their families as Empowerment Strategies. This study examines the main concerns of Cameroonian FSW and proposes interventions to reduce FSW-specific HIV risks.

Methods:  Key informants with allies, in-depth interviews and focus groups with FSW were conducted. Interviews were semi-structured using a guide to describe the FSW social context, FSW knowledge of HIV-related risks and how to improve FSW healthcare services. 
Using a codebook, coded texts were analyzed for recurring themes that led to results.

Results:  First, FSW mothers reported being overwhelmed with physical violence and sexual assault, and demands for bribes to avoid fines and/or prison. They described strategies such as “looking out for” each other when faced with security threats.
Second, many FSW reported staying in sex work so that their children will be financially stable and become college-educated. This will allow their children to “lead a better life” given Cameroon's weak employment situation and sex work's high HIV risk.
Third, FSW mothers did not use condoms when clients offered higher pay, or with intimate partners, even if they understood the risks of HIV transmission to themselves.

Conclusions:  Cameroonian FSW mothers are striving to create family-driven Empowerment Strategies. These FSW are concerned about their children's quality of life over HIV/AIDS risks. FSW consider their children's health risks independent of their own even if they are the children's primary carers. An FSW empowerment program emphasizing family-oriented HIV/AIDS services would offer an influential, novel approach in Cameroon.