Experiences of Sex Workers in Chicago during COVID-19: A Qualitative Study.

COVID-19 exacerbated health disparities, financial insecurity, and occupational safety for many within marginalized populations. This study, which took place between 2019 and 2022, aimed to explore the way in which sex workers (n = 36) in Chicago were impacted by COVID-19. We analyzed the transcripts of 36 individual interviews with a diverse group of sex workers using thematic analysis. Five general themes emerged regarding the detrimental impact of COVID-19 on sex workers: (1) the impact of COVID-19 on physical health; (2) the economic impact of COVID-19; (3) the impact of COVID-19 on safety; (4) the impact of COVID-19 on mental health; and (5) adaptive strategies for working during COVID-19. Participants reported that their physical and mental health, economic stability, and safety worsened due to COVID-19 and that adaptive strategies did not serve to improve working conditions. Findings highlight the ways in which sex workers are particularly vulnerable during a public health crisis, such as COVID-19. In response to these findings, targeted resources, an increased access to funding, community-empowered interventions and policy changes are needed to protect the health and safety of sex workers in Chicago.

Conducting Violence and Mental Health Research with Female Sex Workers during the COVID-19 Pandemic: Ethical Considerations, Challenges, and Lessons Learned from the Maisha Fiti Study in Nairobi, Kenya.

Conducting violence and mental health research during the COVID-19 pandemic with vulnerable groups such as female sex workers (FSWs) required care to ensure that participants and the research team were not harmed. Potential risks and harm avoidance needed to be considered as well as ensuring data reliability. In March 2020, COVID-19 restrictions were imposed in Kenya during follow-up data collection for the Maisha Fiti study (n = 1003); hence data collection was paused. In June 2020, the study clinic was re-opened after consultations with violence and mental health experts and the FSW community. Between June 2020 and January 2021, data were collected in person and remotely following ethical procedures. A total of 885/1003 (88.2%) FSWs participated in the follow-up behavioural-biological survey and 47/47 (100%) participated in the qualitative in-depth interviews. A total of 26/885 (2.9%) quantitative surveys and 3/47 (6.4%) qualitative interviews were conducted remotely. Researching sensitive topics like sex work, violence, and mental health must guarantee study participants' safety and privacy. Collecting data at the height of COVID-19 was crucial in understanding the relationships between the COVID-19 pandemic, violence against women, and mental health. Relationships established with study participants during the baseline survey-before the pandemic-enabled us to complete data collection. In this paper, we discuss key issues involved in undertaking violence and mental health research with a vulnerable population such as FSWs during a pandemic. Lessons learned could be useful to others researching sensitive topics such as violence and mental health with vulnerable populations.

Struggling, Forgotten, and Under Pressure: A Scoping Review of Experiences of Sex Workers During the COVID-19 Pandemic.

The COVID-19 pandemic profoundly affected physical, mental, and economic well-being across the globe and has disproportionately affected certain vulnerable groups. This paper provides a scoping review of literature on the impact of the COVID-19 pandemic on sex workers, published between December 2019 and December 2022. Six databases were systematically searched, identifying 1009 citations; 63 studies were included in the review. Thematic analysis revealed eight main themes: financial issues; exposure to harm; alternate ways of working; COVID-19 knowledge, protective behaviors, fear, and risk; well-being, mental health, and coping; access to support; access to health care; and the impact of COVID-19 on research with sex workers. COVID-associated restrictions led to reduced work and income, leaving many sex workers struggling to cover basic needs; additionally, government protections excluded those working in the informal economy. Fearing the loss of their already reduced number of clients, many felt compelled to compromise both prices and protective measures. Although some engaged in online sex work, this raised concerns about visibility and was impossible for those without technological access or skills. Many feared COVID-19, but felt pressure to continue working, often with clients who refused to wear masks or share exposure history. Other negative impacts on well-being related to the pandemic included reduced access to financial support or health care. Marginalized populations (and especially those in professions which require close contact like sex workers) need further support and capacity-building within the community to recover from the impact of COVID-19.

Heightened risk of unintended pregnancy among sex workers and sex worker organizations' response during the stringent COVID-19 containment measures in East and Southern Africa.

The UNFPA 2022 State of the World Population (SWOP) report recognises that certain populations of young women and girls are at a higher risk of unintended pregnancy, but did not adequately address the grave situation of female sex workers (FSWs), who experience the worst sexual and reproductive health outcomes, especially during humanitarian crises. This study assesses the risks of unintended pregnancy among FSWs and sex worker organizations? response during the stringent COVID-19 containment measures in East and Southern Africa (ESA). A mixed-methods approach consisting of a desk review, key informant interviews and an online survey was used for data collection. Key informants and survey respondents included representatives of sex worker-led organisations and networks, organisations providing services to sex workers, development partners, advocacy organisations and donors, with priority given to key informants who had direct experience of providing services to sex workers during the COVID-19 pandemic. In total, 21 key informants were interviewed and 69 respondents participated in the online survey, with representation from 14 out of 23 countries in the ESA region. The study findings show that the disruption to livelihoods and threats to human rights occasioned by the stringent COVID-19 containment measures intersected with sex workers' access to contraception and risk of unintended pregnancy. Looking to the uncertain future of humanitarian crises, the study concludes by outlining critical issues that need to be addressed to ensure resilience of SRHR services for populations in vulnerable positions, such as sex workers.

Assessment of COVID-19 Impact on Commercial Sex Workers in India: A Formative Research by Media Scanning.

Background: The COVID-19 pandemic restricted movement, closed businesses, and economic activities which disproportionately affected people globally. This pandemic has resurfaced the existing cracks in the societal set-up and has pushed the vulnerable and marginalized communities like migrant workers, people with disabilities, geriatric population, and commercial sex workers (CSWs) to an edge for their existence. Materials and Methods: Due to the paucity of peer-reviewed research publications on CSWs, formative research was conducted to identify the determinants and attributes of the challenges faced by CSWs during COVID-19 situation in India. Media scanning approach was used to collate literature from newspaper and magazine reporting, and peer-reviewed articles were referred from research-based search engines. Results: In total, 31 articles were included for content analysis and four domains of issues i.e., economic, social, psychological and health related challenged faced by them were identified which are supported with the verbatims of the community members as reported in the data sources considered for this study. It was identified that the CSWs adopted several protective measures and coping strategies to deal with the pandemic situation. Conclusion: This research highlighted that there is a need for further exploration of issues among CSWs by conducting studies among the communities. Furthermore, this paper provides a scope for future implementation research by identifying the key priorities and determinants of the challenges among the personal livelihood of CSWs in the country.

Examining Cash Expenditures and Associated HIV-Related Behaviors Using Financial Diaries in Women Employed by Sex Work in Rural Uganda: Findings from the Kyaterekera Study.

BACKGROUND: Women employed by sex work (WESW) have a high risk of human immunodeficiency virus (HIV) infection and experience economic barriers in accessing care. However, few studies have described their financial lives and the relationship between expenditures and HIV-related behaviors. METHODS: This exploratory study used financial diaries to collect expenditure and income data from WESW in Uganda over 6 months. Data were collected as part of a larger trial that tested the efficacy of an HIV prevention intervention method. Descriptive statistics were used to quantify women's income, relative expenditures, and negative cash balances. Bivariate and multivariate logistic regressions were used to examine the odds of sexual risk behavior or use of HIV medications for several cash scenarios. RESULTS: A total of 163 WESW were enrolled; the participants mean age was 32 years old. Sex work was the sole source of employment for most WESW (99%); their average monthly income was $62.32. Food accounted for the highest proportion of spending (44%) followed by sex work (20%) and housing expenditures (11%). WESW spent the least on health care (5%). Expenditures accounted for a large but variable proportion of these women's income (56% to 101%). Most WESW (74%) experienced a negative cash balance. Some also reported high sex work (28%), health care (24%), and education (28%) costs. The prevalence of condomless sex (77%) and sex with drugs/alcohol (70%) was high compared to use of ART/PrEP (Antiretroviral therapy/Pre-exposure prophylaxis) medications (45%). Women's cash expenditures were not statistically significantly associated with HIV-related behaviors. However, the exploratory study observed a consistent null trend of lower odds of condomless sex (adjusted odds ratio (AOR) = 0.70, 95% confidence interval (CI): 0.28-1.70), sex with drugs/alcohol (AOR = 0.93, 95% CI: 0.42-2.05), and use of ART/PrEP (AOR = 0.80, 95% CI: 0.39-1.67) among women who experienced a negative cash balance versus those who did not. Similar trends were observed for other cash scenarios. CONCLUSION: Financial diaries are a feasible tool to assess the economic lives of vulnerable women. Despite having paid work, most WESW encountered a myriad of financial challenges with limited spending on HIV prevention. Financial protections and additional income-generating activities may improve their status. More robust research is needed to understand the potentially complex relationship between income, expenditures, and HIV risk among vulnerable sex workers.

Exploring the lived experiences of women in sex work in Cucuta, Colombia

In the past five years, Colombia has received an influx of migrants with the political and economic crisis in Venezuela. While Colombia has accepted over one million individuals, many displaced individuals find their situations challenging to provide for themselves and their families;for this reason, many women have turned to sex work as a source of income (Ramsey & Sanchez-Garzoli, 2018). In Colombia, sex work is legal, yet it is unregulated, and much stigma persists, which limits access to formal social services (Doocy et al., 2019). In addition, the Covid-19 pandemic has brought additional challenges to both migrants and women involved in sex work (Kimani et al., 2020). This research examines the lived experiences of Colombian and Venezuelan women in sex work during the Covid-19 pandemic in Cucuta, Colombia.To conduct this study, 22 in-depth interviews were conducted with women involved in sex work: 12 Venezuelan and 10 Colombian in Cucuta, Colombia. Interviews were conducted from June to July 2021 in Spanish and were audio-recorded with the consent of each of the women. The women ranged in age from 18-59 years (m=33.1), and all interviews were conducted in the neighborhood of the workplaces of the individuals. Interviews were transcribed and translated to English and input into NVivo for thematic analysis.Chapter Two Findings: The women involved in sex work shared their experiences and the impact of Covid-19 on their work. Venezuelans shared their migration stories and their journeys into sex work and the changes to the industry since the Covid-19 pandemic. The women also shared their reactions to Covid-19 and their plans for 'after' the pandemic.Chapter Three Findings: Covid-19 had an impact on the human rights of the women. Through an observation of the Universal Deceleration Model, themes emerged relating to the working conditions and adequate living standards of the women. The women discussed their hardships with obtaining groceries, paying rent, accessing medical care for themselves and their children, and their working conditions since Covid-19.Chapter Four Findings: Social support for women in sex work and migrants is essential. The majority of the women relied on informal support services such as family members. Limited support is provided amongst the women because of competition and stigmas. For the women who have desired formal social support, limited services were provided. Through the observation of the social services available for the women, a gap persists in the desired and the availability of services.Implications:This research has various implications for social work practice and future search. This research demonstrates the importance of practicing self-determination, empowerment, and dignity and worth of a person when working with women in sex work. Advocacy and community awareness are important to decrease the stigma received by women and to promote the human rights and decriminalization of sex work. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Impact and cost-effectiveness of the national scale-up of HIV pre-exposure prophylaxis among female sex workers in South Africa: a modelling analysis.

INTRODUCTION: In 2016, South Africa (SA) initiated a national programme to scale-up pre-exposure prophylaxis (PrEP) among female sex workers (FSWs), with ∼20,000 PrEP initiations among FSWs (∼14% of FSW) by 2020. We evaluated the impact and cost-effectiveness of this programme, including future scale-up scenarios and the potential detrimental impact of the COVID-19 pandemic. METHODS: A compartmental HIV transmission model for SA was adapted to include PrEP. Using estimates on self-reported PrEP adherence from a national study of FSW (67.7%) and the Treatment and Prevention for FSWs (TAPS) PrEP demonstration study in SA (80.8%), we down-adjusted TAPS estimates for the proportion of FSWs with detectable drug levels (adjusted range: 38.0-70.4%). The model stratified FSW by low (undetectable drug; 0% efficacy) and high adherence (detectable drug; 79.9%; 95% CI: 67.2-87.6% efficacy). FSWs can transition between adherence levels, with lower loss-to-follow-up among highly adherent FSWs (aHR: 0.58; 95% CI: 0.40-0.85; TAPS data). The model was calibrated to monthly data on the national scale-up of PrEP among FSWs over 2016-2020, including reductions in PrEP initiations during 2020. The model projected the impact of the current programme (2016-2020) and the future impact (2021-2040) at current coverage or if initiation and/or retention are doubled. Using published cost data, we assessed the cost-effectiveness (healthcare provider perspective; 3% discount rate; time horizon 2016-2040) of the current PrEP provision. RESULTS: Calibrated to national data, model projections suggest that 2.1% of HIV-negative FSWs were currently on PrEP in 2020, with PrEP preventing 0.45% (95% credibility interval, 0.35-0.57%) of HIV infections among FSWs over 2016-2020 or 605 (444-840) infections overall. Reductions in PrEP initiations in 2020 possibly reduced infections averted by 18.57% (13.99-23.29). PrEP is cost-saving, with $1.42 (1.03-1.99) of ART costs saved per dollar spent on PrEP. Going forward, existing coverage of PrEP will avert 5,635 (3,572-9,036) infections by 2040. However, if PrEP initiation and retention doubles, then PrEP coverage increases to 9.9% (8.7-11.6%) and impact increases 4.3 times with 24,114 (15,308-38,107) infections averted by 2040. CONCLUSIONS: Our findings advocate for the expansion of PrEP to FSWs throughout SA to maximize its impact. This should include strategies to optimize retention and should target women in contact with FSW services.

Poverty, Psychological Distress, and Suicidality Among Gay Men and Transgender Women Sex Workers During the Covid-19 Pandemic in Phuket, Thailand.

Introduction: Thai gay men and transgender women (GM&TGW) sex workers are more likely to suffer from economic harm since the sex tourism industry in Thailand has been hit hard by the Covid-19 pandemic. They also are more likely to experience poverty and mental health issues subsequent to the pandemic as minority groups in conservative Thai society. While their highly problematic social and economic situation would predict a wide range of psychological issues, little is known about their mental health. Hence, this study examined the prevalence and symptom severity of psychological distress among the group as well as the associations between suicidal ideation, poverty, and psychological distress. Methods: Two hundred seventy questionnaire responses were collected online via Google forms in Phuket in 2021. Data analysis was conducted using SPSS and Smart-PLS. Results: Based on the results, most respondents had experienced mild to extremely severe symptoms of psychological distress. However, transgender women sex workers scored higher on depression and anxiety compared to gay men sex workers. This study confirmed the prominent associations between the study variables and the mediation effect of psychological distress. Conclusions: Poverty resulting from the pandemic imposes a substantial human cost for this vulnerable minority beyond the virus itself as it amplifies mental health problems. Policy Implications: The findings further extend our awareness of the discriminatory treatment of Thai GM&TGW sex workers and address a gap in Thai law and policy for prohibiting discrimination against them. It is of urgent necessity for Thai public health and tourism policymakers to establish sound support interventions.

Shan Female Sex Workers' Vulnerabilities and Coping Strategies in Response to COVID-19 in Chiang Mai, Thailand

The Thailand government has marginalized, criminalized, and discriminated against migrant sex workers for decades and the COVID-19 pandemic has only increased the vulnerability of sex workers to hardship. Using a mixed research methodology including interviews, this article outlines the risks Shan sex workers in northern Thailand faced during the COVID-19 pandemic that began in 2020, their vulnerability contexts, and their coping strategies, including how institutional aid and existing assets impacted their livelihoods. Our findings reveal that Shan sex workers in Thailand have suffered primarily from oppressive laws and social stigma. They were excluded from government COVID-19 mitigation measures such as health services, compensation, and economic support. Identifying vulnerability factors highlights the difficulties of both systemic and individual-level responses, leading to suggestions for policymaking to improve the quality of sex workers' lives. This study reveals that Shan sex workers are still being left behind and discriminated against in Thailand, but they have persevered to speak their minds and struggle to live through the COVID-19 crisis. There is an urgent need for Thailand authorities to decriminalize sex work and restructure the social security system so that it is inclusive for migrants.

Peer community health workers improve HIV testing and ART linkage among key populations in Zambia: retrospective observational results from the Z-CHECK project, 2019-2020.

INTRODUCTION: Zambia has made tremendous progress towards HIV epidemic control; however, gaps remain among key populations (KPs), such as female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and people in prisons and enclosed settings due to cultural, social and legal barriers. The University of Maryland, Baltimore Zambia Community HIV Epidemic Control for Key Populations (Z-CHECK) project aimed to improve HIV case-finding, linkage and treatment adherence at the community level for KPs in Zambia. We describe Z-CHECK strategies and examine HIV positivity yield and antiretroviral therapy (ART) linkage among KPs to inform ongoing programme improvement. METHODS: Z-CHECK recruited, trained and deployed peer community health workers (CHWs) for KP groups, with ongoing mentorship in community engagement. CHWs offered HIV testing in safe spaces and escorted newly HIV-diagnosed clients for same-day ART initiation. Z-CHECK also reached out to KP community leaders and gatekeepers for KP mobilization and trained healthcare workers (HCWs) on KP services and sensitivity. We conducted a retrospective observational review of routinely collected aggregate data for KPs aged ≥15 years at high risk for HIV transmission across five districts in Zambia from January 2019 to December 2020. RESULTS: Z-CHECK provided HIV testing for 9211 KPs, of whom 2227 were HIV positive (positivity yield, 24%). Among these, 1901 (85%) were linked to ART; linkage for MSM, FSW, PWID and people in prisons and enclosed settings was 95%, 89%, 86% and 65%, respectively. Programme strategies that contributed to high positivity yield and linkage included the use of peer KP CHWs, social network testing strategies and opportunities for same-day ART initiation. Challenges to programme implementation included stigma and discrimination among HCWs, as well as KP CHW attrition, which may be explained by high mobility. CONCLUSIONS: Peer CHWs were highly effective at reaching KP communities, identifying persons living with HIV and linking them to care. Engaging KP community gatekeepers resulted in high diffusion of health messages and increased access to health resources. The mobility of CHWs and HCWs is a challenge for programme implementation. Innovative interventions are needed to support PWID and people in prisons and enclosed settings.

HIV Voluntary Counseling and Testing (VCT-HIV) effectiveness for sexual risk-reduction among key populations: A systematic review and meta-analysis.

Background: HIV disproportionately affects people who inject drugs, transgender people, sex workers, men who have sex with men, and incarcerated people. Recognized as key populations (KP), these groups face increased impact of HIV infection and reduced access to health assistance. In 1990, the Center for Disease Control and Prevention organized technical guidance on HIV Voluntary Counseling and Testing (VCT-HIV), with subsequent trials comparing intervention methodologies, no longer recommending this strategy. However, KP needs have not been explicitly considered. Methods: We assessed VCT-HIV effectiveness for sexual risk-reduction among KP (PROSPERO 2020 CRD42020088816). We searched Pubmed, EMBASE, Global Health, Scopus, PsycINFO, and Web of Science for peer-reviewed, controlled trials from February, 2020, to April, 2022. We screened the references list and contacted the main authors, extracted data through Covidence, applied the Cochrane Risk-of-Bias tool, and performed the meta-analysis using Review Manager. Findings: We identified 17 eligible trials, including 10,916 participants and evaluated HIV risk behaviors. When compared to baseline, VCT-HIV reduced unsafe sex frequency (Z=5.40; p<0.00001, I²=0%). Interpretation: While our meta-analysis identified VCT-HIV as protective for sexual risk behaviors for among KP, the results are limited to MSM and PWID, demonstrating the paucity of data on the other KP. Also, it highlights the importance of applying a clear VCT-HIV guideline as well as properly training the counselors. Funding: Research funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ/MS-DIAHV N° 24/2019), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.

Utilisation of HIV services by female sex workers in Zimbabwe during the COVID-19 pandemic: a descriptive phenomenological study.

This study focuses on female sex workers as a key population group that suffers a degree of vulnerability according to the World Health Organisation (WHO). Key populations refer to people at heightened risk of contracting the human immunodeficiency virus (HIV) due to specific behaviours and social and legal environments which increase their vulnerability to the virus. Key populations are disproportionately affected by HIV, yet they have less access to HIV services compared to the general population. The coronavirus (COVID-19) lockdown and its restrictive measures have further widened the inequalities and gaps in accessing HIV services for this group. A descriptive phenomenological study was undertaken to explore female sex workers' experiences of utilisation of HIV services during COVID-19. The study setting was the Bulawayo Metropolitan Province, Zimbabwe. Data were collected through in-depth individual interviews with 10 female sex workers. Purposive sampling coupled with snowballing was utilised for recruiting participants. Data were analysed guided by the seven-step Colaizzi technique. Rigour was ensured through adhering to Lincoln and Guba's trustworthiness criteria. The study found that the COVID-19 pandemic adversely affected the livelihoods of sex workers and their utilisation of HIV services. There was limited access to HIV services due to an initial lack of travel authorisation letters and financial challenges experienced by study participants. In addition, the quality of care in health care facilities was further compromised by poor screening processes and reduced provider-client interactions. Maintaining access to HIV services for female sex workers during pandemics is critical for the country to attain HIV epidemic control.

An intimate portrait of shared trauma amid COVID-19 and racial unrest between a Black cisgender femme sex worker and her Black cisgender femme therapist

This chapter describes the emotional impact of shared cultural trauma experiences in the psychotherapeutic interaction between Dana, a Black cisgender female sex worker, and her current therapist, also a Black cisgender female. Both appreciate that Dana's narrative of her psychological challenges is unusual and that exposure is risky because of the clandestine nature of the sex industry and safety concerns. This is a primary reason that the voices of Black cisgender female sex workers are generally not reflected in academic research and literature. Current shifts in the sociopolitical climate are creating space for sex workers of color to enter unfamiliar and uncomfortable fora to procure appropriate representation, protection, access to resources, and emotional support. For these reasons, Dana has chosen to make her voice count. Her therapist also shares her own personal and professional reflections on the convergence of the pandemics. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

How do you expect us to survive? Lamentation of female sex workers in Zimbabwe during COVID-19 lockdown

The restrictive measures taken to curb and mitigate the spread of the corona virus (COVID-19) had negative implications on the vulnerable populations. Of the latter, the most severely affected were sex workers, whose work venues and customers were locked down. This descriptive phenomenological study explored effects of COVID-19 on female sex workers in Bulawayo, Zimbabwe. Snowballing sampling was used to recruit participants. Data were collected through in-depth face-to-face individual interviews with ten female sex workers. The sample size was determined by data saturation. Colaizzi's seven-step content analysis approach was followed to guide data analysis. Rigour was ensured by adhering to Guba and Lincoln's trustworthiness criteria. The study found that the measures impacted negatively on sex workers' income, making it difficult for them to get money for food and rentals. In response, some sex workers adopted innovative entrepreneurship. Others engaged in risky sexual behaviours, further aggravating their situation emotionally and psychologically. It is recommended that the government and policy makers provide psychosocial and economic support to protect the rights of female sex workers in order to maintain the gains made in HIV response.

Sex Workers and Livelihoods under the COVID-19 Pandemic in the City of Masvingo, Zimbabwe

Pandemic diseases have always disrupted the livelihoods of people. “Key populations” such as commercial sex workers (CSWs), who are not legally recognized in Zimbabwe, have been affected during pandemics and disasters through loss of their livelihoods. The study sought to determine the extent to which the COVID-19 pandemic has affected the livelihoods of sex workers in the city of Masvingo, Zimbabwe. A mixed methods approach was adopted for this study where both quantitative and qualitative methods were used. Quantitative data were collected through 200 questionnaires out of an estimated population of 600. The study used expert and purposive sampling and employed unstructured interviews to capture the experiences of the target populations during the COVID-19 pandemic. Quantitative data is presented in the form of tables and figures, and inferential statistics models are used to analyze quantitative data. A thematic approach was used to present and analyze qualitative data. Results of the study indicate that the COVID-19 pandemic aggravated the socio-economic situation of commercial sex work (CSW) through loss of income. Findings further indicate that as companies reduced the number of workers reporting for duty daily, contract workers who include sex workers were the first to be placed on forced leave, resulting in loss of their only source of alternative formal income. Many sex workers were restricted from accessing sexual and reproductive health and from collecting their medical supplies and contraceptives as security forces mounted checkpoints that denied people entry into town. It is recommended that Zimbabwean legal and labor instruments must recognize individuals engaged in commercial sex work so as to reduce their vulnerability during pandemics and other disasters. © 2021 Ulster Institute for Social Research. All rights reserved.

“If Things Really Go On as They Are at the Moment, Then I Will Work Illegally. End of Story.” Pandemic Realities in Marginalized Entrepreneurships

Micro-enterprises and self-employed individuals have been hit particularly hard by the economic effects of the COVID-19 pandemic, but few studies have tackled the issue. This paper is based on four in-depth case studies of self-employed people from different sectors who have been greatly affected by measures taken to control the pandemic. By capturing shifts in the perception of institutional and economic pressures, as well as precarity after the outbreak of COVID-19, we gained profound insight into crisis management among entrepreneurs working in niche or marginalized fields of business. We found parallels in their biographies and attitudes, but their perceptions of the COVID-19 pandemic differ. We observed paradoxes and hybrid logic, as well as different ways of coping with the crisis. Having a “plan B” helped in some cases, while all of them benefitted from the solidarity of networks and communities. © 2022 QSR V.

Protecting HIV service delivery for key populations in southern Africa in the context of the COVID-19 pandemic.

The 2025 UNAIDS targets prioritize reaching all subpopulations living with HIV and those at risk for HIV as the only pathway to achieving control of the HIV epidemic. This has brought to the fore the importance of addressing the needs of key marginalized groups and placing such communities at the center of HIV response strategies. However, the COVID-19 pandemic has resulted in a setback in terms of confronting HIV. With this in mind, it is important not only to protect services within HIV responses among key populations, but also to expand such services to meet the UNAIDS 2025 targets. Without this, gains in controlling COVID-19 may be achieved at the expense of losses in controlling the spread of HIV, which had been achieved after sustained and resource-intensive actions.

“Dirty Work” in the Context of COVID-19: Sex Workers’Adaptation in Taiwan

The COVID-19 pandemic primarily affects people in precarious conditions, and sex workers are in a vulnerable position because their occupation is usually considered “dirty work.” Examining the cases in Taiwan, we find that contrary to general imagination, sex workers managed to make their living not only by diversifying their economic activities but also by reorganizing their core services—sex. Moreover, they were able to adapt their relations with peers and clients and gained social capital that empowered them to alleviate negative impacts brought by the pandemic. Copyright © 2021 by the Society for Applied Anthropology

Behavioral Changes, Adaptation, and Supports among Indonesian Female Sex Workers Facing Dual Risk of COVID-19 and HIV in a Pandemic.

The objective of this study is to explore the impacts of COVID-19 and changes taking place among the Indonesian female sex worker (FSW) community during the COVID-19 pandemic and the predictors of these changes. We conducted a cross-sectional online survey and selected the participants using a purposive snowball sampling technique. Incentives were provided to participants in the form of a 5 USD e-wallet balance. Variables of interest included adaptation to online sex work, adherence to COVID-19 prevention measures during sex work, number of clients, income reduction, social support, condom access, and condom use frequency. Sociodemographic data and COVID-19 fear index values were also collected. Final analysis included 951 FSWs, of whom 36.4% of had adapted to online sex work and 48.6% had practiced COVID-19 prevention measures. Major reductions in client frequency and income were reported by 67.8% and 71.1% of respondents, respectively. However, only 36.3% of FSWs reported they had ever received any form of social support from any parties, public or private. Meanwhile, 16.7% encountered difficulties in accessing condoms and 12.5% reported less frequent condom use during the pandemic. Easy access to condoms was the main factor influencing the frequency of condom use. As expected, staying in employment protected FSWs from major income loss, while education and younger age predicted adaptive behavioral changes, such as taking up online sex work. The COVID-19 pandemic has disrupted access to socioeconomic support systems and HIV prevention services among FSWs and has further exposed them to the dual jeopardy of HIV and COVID-19 infections.