“Many People Do Not Consider Us Human” Violence Against Commercial Sex Workers in Gondar City: A Phenomenological Study

Abstract

Sex workers are a marginalized group that often faces a heightened risk of experiencing violence, however little is known from the perspectives of sex workers in Ethiopia. Therefore, this study was conducted to explore the violence experienced by commercial sex workers in Gondar City, Northwest Ethiopia. An exploratory qualitative study using a phenomenology approach was conducted from October to November 2020 in Gondar City. A snowball purposive sampling method was used to recruit 12 commercial sex workers. A face-to-face in-depth interview was conducted. The collected data were analyzed using the thematic analysis approach. Open code version 3.1 software was used for data analysis. Commercial sex workers experienced substantial violence during their work. Sexual, physical, psychological, economic, and structural violence, perpetrators, and mechanisms to deal with the violence were the main themes that emerged from the analysis. Sexual violence mainly occurred from disagreement on sex without a condom, sexual position, a request for oral and anal sex, and extended duration of intercourse were a source of all other types of violence. Commercial sex workers experienced considerable sexual, physical, emotional, and economic violence. It is recommended that efforts should be made to raise awareness about women’s rights and their need for legal and healthcare services. Additionally, it emphasizes the importance of providing life skills to empower women, such as financial, domestic, survival, goal-setting, communication, relationship-building, boundary-setting, and problem-solving skills. These skills are mentioned as a means to help prevent or reduce the violence experienced by commercial sex workers.

Plain language summary

Globally, commercial sex workers have a 45 to 75% risk of experiencing sexual violence while a 32 to 55% chance of experiencing sexual violence in a year. Many quantitative researches show that violence is prevalent among commercial sex workers, however little is known from the perspectives of sex workers in Ethiopia. Therefore this study was conducted to explore the violence experienced by commercial sex workers in Gondar City, Northwest Ethiopia. Methods: An exploratory qualitative study using a phenomenology approach was conducted from October to November 2020 in Gondar City.

Background

A broad variety of practices related to the exchange of money (or its equivalent) for the provision of sexual services is considered commercial sex work. It involves a sex worker, a client, and a third party like hotel managers, brothel keepers, drivers, and receptionists (Balfour, 2014; Choi & Holroyd, 2007). Sex workers are individuals “who receive money or goods in exchange for sexual services, and who consciously defined those activities as income generating” (Berg, 2014). Sex workers face high levels of violence as a result of their risky work environment (they work in isolated areas). Furthermore, they evade law enforcement due to corruption or lack of trust, as well as the fear of being stigmatized as criminals and facing punitive actions from the criminal justice system, which ideally should be safeguarding their rights (McBride et al., 2020).

A substantial body of evidence strongly suggests that violence is a prominent feature in the lives of commercial sex workers in all settings of sex work (Balfour, 2014). Globally, commercial sex workers have a 45% to 75% risk of experiencing sexual violence while a 32% to 55% chance of experiencing sexual violence in a year (Deering et al., 2014; Footer et al., 2018; Koster, 2015; Overs, 2002). Violence against sex workers is correlated with inconsistent or lack of condom use and is recognized as a risk factor for HIV and other sexually transmitted infections (STIs; World Health Organization et al., 2013). It is also a barrier to effective STI prevention among commercial sex workers and the general population. There is evidence indicating that sexual violence can stem from disputes related to condom use, sexual positions, requests for specific sexual acts (such as oral or anal sex), and the duration of intercourse (Choi & Holroyd, 2007; Decker, Wirtz et al., 2013; Deering et al., 2013; Mooney et al., 2013; Sherwood et al., 2015; Ulibarri et al., 2013). The women are put at direct risk of HIV/STIs during forced sex which increases the likelihood of HIV infection of the perpetrators. Forced sex is associated with increased stigma, social vulnerability, and decreased care-seeking for health issues (Balfour, 2014; Sherwood et al., 2015).

Violence against sex workers is not just a violation of human rights, but it can also have a negative impact on their health (Decker et al., 2015). Women and girls who work in the sex trade face numerous dangers, including being beaten, raped, robbed, being harassed, not receiving payment, and facing social stigma directed at themselves and their children. In addition, they are a victim of homicide (Potterat et al., 2004). Evidence shows that there are interlinked consequences of violence including physical, and sexual trauma; lack of access to legal, health, and other social services; loss of income, employment, housing, and educational opportunities, posttraumatic stress disorder (PTSD), depression, and anxiety (Beattie et al., 2020; Elmes et al., 2022; Evens et al., 2019; Roxburgh et al., 2006).

Sex workers are severely stigmatized and exposed to social and political discrimination in many nations (Alemayehu et al., 2015; Mooney et al., 2013). The legal framework in Ethiopia focuses on rehabilitation and reintegration for individuals engaged in sex work, rather than criminalization. However, according to Article 634 of the Ethiopian Penal Code “whoever, for gain, makes a profession of or lives by procuring or on the prostitution or immorality of another, or maintains, as a landlord or keeper, a brothel, is punishable with simple imprisonment and fine” (Ethiopia F, 2004). The harm experienced by sex workers is often socially invisible and not adequately addressed in the legal framework. The stigmatization and marginalization of sex work contribute to this invisibility, as it can lead to the neglect or dismissal of the rights and well-being of sex workers. Thus, violence against commercial sex workers is considered as a feature of the work; policies and strategies are not addressed well enough a major public health problem. Quantitative research indicates that violence is inherent and prevalent among commercial sex workers (Alemayehu et al., 2015; Hiwot & Yohannes, 2012; Mooney et al., 2013), however little is known from the perspectives of sex workers in Ethiopia. The qualitative approach is suitable for exploring the experience of sex workers facing violence Therefore, this study aimed at exploring the violence-related lived experiences of commercial sex workers in Gondar city, northwest Ethiopia. The study provides scientific evidence for policymakers to revise and strengthen the existing rules and regulations to protect the rights of sex workers, health advocators, and scientific communities about the forms of violence among commercial sex workers and coping strategies. In addition, it also addresses the reasons some engage in commercial sex work and serves as a source for further studies on violence in commercial sex workers.

Methods

Study Setting and Period

The study was conducted in Gondar city, located 728 km from Addis Ababa, the capital city of Ethiopia. Gondar had an estimated total population of 500,788, of whom 300,000 were men and 200,788 women. The majority of the inhabitants (90.2%) are affiliated with the Ethiopian Orthodox Christian church, while 8% of the population were Muslim and 1.1% were protestant. According to Mahibere hiwot (NGO; which serves the community and especially commercial sex workers) report shows that there are around 2,300 commercial sex workers. Gondar is an ancient historic site which a number of tourists visiting it. The study was conducted from October to November 2020.

Study Approach and Selection of Study Participants

A phenomenology study approach was employed to understand the hidden meanings and essences of lived experience. It is recommended that researchers who want to conduct a phenomenological study must therefore locate participants who have experienced the phenomenon in our case violence, and who are able to explain their experiences to the interviewer effectively (Osborne, 1994). Snowball purposive sampling method was used to recruit study participants. First, we approached health extension workers (a type of healthcare provider who treats patients and offers various community health services) and a volunteer peer educator working with commercial sex workers, though they themselves had no history of sex work. They were familiar with the sex workers through their community service. They then introduced us to a sex worker. We conducted our first interview with this commercial sex worker, who then assisted us in identifying the next study participant by providing information on where most sex workers could be accessed. The participant recruitment continued in such a way until we reached the level of saturation, the interview ceased after three continuous similar findings. Twelve commercial sex workers who worked for at least 12 months and experienced one form of violence were included in this study.

Data Collection Procedure

Data was collected through face-to-face in-depth interviews using a semi-structured guide. The interviews were conducted in a private setting with minimal sound disturbance, ensuring convenience for the study participants. The time and place of the interview was determined by the interviewees themselves. The interview guide was prepared in English language and translated into Amharic (local language). The four of the authors (HB, AZ, AK, and SH) conducted in-depth interviews. The data collectors had experience in qualitative research data collection and analysis. The data was recorded using a voice recorder and notes were taken by the investigators. The interviews took from a minimum of 30 min to a maximum of 1 hr and 2 min. To ensure data quality, the interview guides were reviewed by experts, and pilot interviews were conducted with commercial sex workers to validate them. Based on the findings from the pilot interviews, vague questions and concepts were modified before applying the guides to the actual study participants. The investigators also used simple language and descriptions in conducting the interview. Prolonged engagement and audit trail were considered crucial techniques to ensure the authenticity and credibility of the results.

Data Analysis

All audiotaped in-depth interviews and field notes were independently transcribed verbatim to Amharic (the local language) after repeatedly listening to the records and then translated into the English language. The translated transcription documents were imported into Open code version 3.1 software of qualitative data analysis for coding and analysis. After repeatedly reading the transcribed document, the investigators coded and categorized the data into themes and sub-themes. Central themes were constructed based on the natural meaning of the categories. The investigators cross-cheeked the themes that emerged after analysis with the respective quotes of the themes. The findings were reported by a detailed description and interpretation of the meanings of the themes. Direct quotes from the participants were also included in the write-up of the findings to provide clear images for readers. The overall process of data analysis used an inductive approach. Finally, these study findings were reported based on the consolidated criteria for reporting qualitative research (COREQ) guidelines (Supplemental Document 1).

Ethics Approval and Consent to Participate

Ethical approval and a permission letter were obtained. The participants were well-informed about the purpose of the study, the data collection procedure, confidentiality, and privacy. They were also informed that they could withdraw from participation at any time as the interview process unfolded. Written informed consent was obtained to undertake audio records from each participant before the interview. Since some of the study participants were unable to read and write, the data collector read the consent form and explained the purpose and procedure of the study. Then, the data collector marked “Yes” on the written consent form when the study participants volunteered to participate in the study and recorded their signature with “thumbprint.” The anonymity and confidentiality of the respondents were ensured.

Results

Background Information of the Study Participants

A total of 12 interviewees who work in brothels, homes, hotels, and street-based participated in this study. The age of the participants ranged from 23 to 45 years old. Many of the participants were unable to read or write, and their highest level of education was completion of grade 10. The women had 4 to 18 years of lived experience in commercial sex work. Many of the participants were originally from rural areas prior to engaging in commercial sex work. The background characteristics of in-depth interview participants were presented in Table 1. Types of violence and coping mechanisms to deal with the violence were the main categories (themes) that emerged from the analysis.

Table 1.

Background Information of the Study Participants (Commercial Sex Workers) in Gondar City Northwest Ethiopia, 2020.

Participant ID	Age	Education	Years in commercial sex work
1	40	Unable to read and write	18 years
2	23	Grade 7	5 years
3	29	Grade 5	4 years
4	28	Unable to read and write	8 years
5	30	Grade 5	10 years
6	30	Unable to read and write	13 years
7	45	Unable to read and write	7 years
8	29	Unable to read and write	4 years
9	38	Unable to read and write	10 years
10	26	Grade 6	3 years
11	37	Grade 8	4 years
12	23	Grade 10	2 years

What Drives Women to Commercial Sex Work?

The main reasons for engaging in commercial sex work were family instability, marriage dissolution, and a lack of money to care for a child. Sex work is sometimes the only viable option for women in countries coping with poverty, and unemployment. Sex work is frequently a more flexible, remunerative, and time-efficient alternative for single moms with children than manufacturing or service employment. Women do not have access to educational opportunities, skills, and knowledge that enable them to improve their lives. Especially in developing countries like Ethiopia, their only fate is often to marry at an early age instead of pursuing education. When a marriage breaks down, the resulting lack of financial resources to meet their own and their children’s needs becomes a primary reason for engaging in commercial sex work. A woman explained this as follows:

Previously I was married. However, it became intolerable to go on. I don’t have a choice … Due to a lack of resource/money, I was unable to serve my child even for the sake of meals. [p#8]

Others’ pressure was also mentioned as a motivator for engaging in commercial sex work. This could come from close friends, hotel managers or owners, or customers, or it could be from witnessing someone whose lifestyle has improved as a result of commercial sex work. For example, the participant explained it as follows:

I worked as a waiter in a hotel; my friends told me about this job [commercial sex work], and they told me they made a lot of money and handed it to me to keep. Then I became interested in doing this work. I wondered why I was so tired as a hotel maid. And I imagined that working in commercial sex would transform my life with low effort … I joined. [p#3]

Violence Against Commercial Sex Workers

Many of the participants experienced at least one or more sexual, physical, psychological/emotional, and economic violence incidents in their work setting. Sexual violence is by far the most common form of violence. Disagreement on condom use and sexual position against one’s will and interest were the key causes of the abuse. It was also the cause of all other types of abuse, physical and emotional violence in particular. Sexual violence increases the prevalence of sexually transmitted diseases (STDs) including HIV in these high-risk groups and the general population at large.

Who Are the Violators?

In this study, the women reported that clients were the most common perpetrators of sexual, physical, psychological, and economic violence. Regular customers, those who are married, and those who are from a long-distance were less likely to be violent. Study participants explained this as follows:

We didn’t always have regular customers … they were the major perpetrators … Our customers engaged in forced sex, striking us, breaking/stealing our goods, refusing to pay us after having sex, and other similar acts. … [P#8]

Some of our clients had their own life (marriage). They didn’t want to collide with us … they will come hiddenly … they feared that getting into trouble with us would reveal their secret. So, they would prefer negotiation than engaging in any form of violence. [P#4]

In the instance of psychological violence, alcohol drinkers, neighborhoods, friends, and other community members also commit the violence.

Almost everyone around us was insulting and humiliating us. Customers, alcoholics, and even our neighbors make fun on us. Many people would not consider us a human being. [P#2]

Sexual Violence

Sexual violence is one of the most common forms of violence and the most serious problem that commercial sex workers experience. It was also the cause of all other types of violence. The commercial sex workers did not have regular customers and most of their clients enforce them to have sex without a condom against one’s will. Other forms of sexual violence include forcing women to have sex in strange sexual positions, oral sex, anal sex, and prolonged intercourse. Clients frequently threatened or acted violently in response to women’s refusals to engage in specific sexual activities, notably anal intercourse, condom nonuse, or dealing with the women at all.

Some men suck my breast and ask me to suck their penis, and they will try to convince me by adding extra money … when I refused them, they would try to do so by coercion. I knocked out one person with a bottle because of such forced sexual acts. [p#1]

The perpetrators will use a variety of techniques that enable them to meet their needs and commit sexual violence. For instance, they encourage the woman to consume heavy drinks or large amounts of alcohol so that they can do whatever they want after she is inebriated. One of the participants stated this:

One of my customers invited me to a lot of alcoholic drinks. Then he took me somewhere and we had sexual intercourse without a condom. A few days later, I heard of that person’s death from HIV/AIDS. But he didn’t tell me whether or not he had the disease. Once upon a time, I got sick … my relative took me to the health center … they told me that I am HIV positive and I became unconscious … [p#6]

Physical Violence

The other type of violence faced by commercial sex workers was physical violence, which was primarily a result of disagreements on sexual matters like forced sexual acts against one’s agreement, and refusal to use condoms. Conflict with abusers was a prominent feature of commercial sex work. This physical violence ranged from minor pushing to forceful punching, and stab injury which leads to loss of consciousness and even death. The women explained such physical violence as follows;

I have had a lot of problems. For example, one of my customers stabbed me with a dagger, and look at this … (Showing the scar on her hand). And he has been arrested and imprisoned for a long time … [p#11]

During the night my customer took me to Paisa (a place found in Gondar city) and asked to had sex without a condom. But I refused. We got into a quarrel and he punched me in my face, and, embrace the pillow firmly over my mouth to keep me from shouting and being heard by others. He forced me to have sex without a condom. At the time, I was unconscious and someone took me to hospital … After that, I will never work at night again. [p#5]

Physical violence was not limited to being slapped, pushed, or hit—an experience commonly expected among commercial sex workers—but, in severe cases, it could even lead to the death of the woman. The participants witnessed the death of their friends due to physical violence. A woman described the condition as follows;

…my friend was killed … I also stayed here, because I didn’t have any other options and decided not to do this work at night. It is safer if I get customers during the day, unless I will not do at night. [p#6]

Psychological Violence

Emotional violence was common among the study participants, which leads to feelings of stress, shame, and embarrassment. For all commercial sex workers, psychological violence like insult, humiliation, intimidation, and warning was a common experience. The woman accepted the insults as their identity. They were labeled by their friends, customers, and neighbors, they were given unique names which described their sexual work which leads them to be isolated from the community.

Insult is common … almost everyone around us insults and humiliates us. Our customers and even alcoholics make fun of us … When we went to a social occasion with others, people didn’t respect us. [P#2]

Similarly, other participant explained her experience as:

… We’ve been called “lame” or AIDS by a woman … She is my neighbor, I told her … don’t say things like that, you might get HIV/AIDS one day since you are not out of this work, … [P#1]

Economic Violence

Economic violence was distinct but common violence among commercial sex workers. This includes withholding, declining, and denying payment, breaking one’s material, and stealing one’s money (Fawole, 2008). Commercial sex workers struggle for daily survival like rent of room and food expenses. For these women, economic violence became an added burden. Here also disagreement on sexual matters became a cause of economic violence. For example, some customers want prolonged intercourse time, and if the women try but fail to meet this demand, they were enforced to return the money back. It is even worse that the men might not even be willing to pay. In such a case, they will have to cover their daily needs on their own. They were unconcerned about the women’s time and energy spent with them. One study participant explained this:

They would not leave me quickly; taking prolonged time to reach orgasm. This becomes a source of conflict. They will say ‘if you can’t stay until we finish, you should return the money back and trouble me. If they intend to harm me, I will refund half their money and let them to leave. In some cases, I may be forced to return all of the money in order to protect my life. [P#12]

Some customers may take women’s goods such as cell phones, bracelets, and other valuable materials. Sex workers are struggling to generate money, feed their children or their family, and pay different debts, but even their customers stole their property, which leads them to a serious economic crisis.

… Six of my phones have been stolen … for the seventh time, I saw him while he pick my phone and put it in his pocket … I returned my phone back … [p#3]

Structural Violence

Sex workers also faced structural violence in the different sectors including the community structures. Commercial sex workers were often excluded from social occasions and interpersonal relationships to the level that they were not considered human beings. Considering them as inferior and dehumanizing these populations is common in society. The community didn’t allow them to participate in social events like wedding ceremonies, coffee ceremonies (which the very famous ceremony in Ethiopia), and funeral ceremonies. In addition, the women were to seek help from police, lawyers, neighbors, and friends, while they reported that they had been violated, some police officers did not support them. The policies, according to the participant, did not treat them similarly and fairly as other people. They would be biased in favor of the culprit. As a result, most commercial sex worker women choose to shout and call their neighbors and friends rather than seek police aid.

… when I was a beginner, I went to the police office. Since there is no solution, nowadays I will not go there … I cried a lot of times, I returned their money even after having sex, … there is no rule and regulation in place to address these issues. We are not equally treated by the law, and no one wants to hear to us … we were not heard before the law, even in our village we were undermined despite our equal contribution in all affairs. [p#4].

Mechanisms for Dealing With Violence

The coping methods employed by commercial sex workers to reduce or halt violence were also investigated in this study. Sexual violence was a source of all other forms of violence, and women dealt in a variety of ways. First, the women try to take one’s measures and then, seek support from external bodies. They started by crying and continued to counter-attack the perpetrators. Returning the money back was also a coping method used by the women. Others physically strike the perpetrator with a stick and a bottle. From all mechanics, returning the money was the most frequent, and also had a positive response.

… I’m powerless in the face of such individuals. Because if you get into a fight with a man, you never know how they will hurt you. If they refuse to accept my idea, I will return their money and let them leave. [P#6]

The other woman explained this as follow:

… I strike a man with a bottle in his head, and he bleeds. The police arrived and arrested me … and they took him to the hospital for treatment … but I told them he forced me to suck his penis … [p#11]

Discussion

Even though commercial sex work is not legal in Ethiopia many women engaged in such activity as a means of daily livelihood. Violence of all kinds is a prominent feature in the life of commercial sex workers. As a result, the current study explored the experiences of violence and coping mechanisms among commercial sex workers in Gondar City. Sexual violence, physical violence, psychological violence, economic violence, structural violence, perpetrators, and mechanisms of dealing with the violence were the main themes that emerged from the analysis.

There are numerous factors that drive women to the engagement in commercial sex work (Balfour, 2014). Marriage dissolution, a lack of funds to support one’s family, homelessness, and peer pressure were identified as the primary motivators for engaging in commercial sex work. Sex work is considered as a means of survival for women, especially after a marriage breaks down. Similarly, a study finding reported peer pressure, poverty, lack of employment, and conflict with family or divorce as major causes to engage in commercial sex work (Genemo & Tito, 2015). Financial problems resulting from the increased living cost are strong factors that drives women to engage in sex work (Balfour, 2014; Curtis et al., 2021; van Blerk, 2016). According to studies, homelessness is the most common reason for women to engage in sex work (Balfour, 2014; Spice, 2007). This implies that when a marriage breakdown happens, there is a change in economic status which makes them unable to support their family and themselves in return for engaging in sex work. This call to work on the core cause of commercial sex work engagement; mainly policies and strategies that encourage and support healthy marriage and, more importantly, improve low-income families specifically single parenthood.

The literature reviewed on the different parts of the world whether sex work is criminalized (the purchase and selling of sexual services are punishable by law) or decriminalized (purchase and selling of sexual services are not prohibited) showed that sex work without violence is impossible, and sexual violence goes hand to hand with physical violence (Aidsfonds, 2018; Cepeda & Nowotny, 2014; Dasgupta, 2021; Javalkar et al., 2019; Otutubikey Izugbara, 2005; Schon & Hoheide, 2021). Sex workers face at least one form of violence in their entire work experience.

Usually, most commercial sex workers consider violence as a part of their job(Alemayehu et al., 2015). In our study commercial sex workers experienced at least one of sexual, physical, psychological/emotional, structural and economic violence during their work. Our study participants commonly reported that sexual violence is endemic, mainly due to disagreement on condom use, sexual acts, and sexual positions against one’s agreement. Consistent with past report client aggression increases HIV risk, with participants reporting coercive condom non-use as well as overt force and coercion for anal intercourse (Aborisade, 2019; Alemayehu et al., 2015; Bosa et al., 2015; Cepeda & Nowotny, 2014; Decker et al., 2016; Decker, Pearson et al., 2013; Genemo & Tito, 2015; Hiwot & Yohannes, 2012; Okal et al., 2011; Sherwood et al., 2015). Sexual violence increases the risk of sexual and reproductive health problems, notably HIV/AIDS and other sexual transmitted infections (Dasgupta, 2021; Deering et al., 2013; Ulibarri et al., 2011). This leads to a devastating effect on the live of the women as well as general population at large. The act of sexual assault also leaves an individual with physical and physiological effects (Nemathaga et al., 2017). These findings specify that sex workers should get the sexual health support that enable them to prevent sexual health problems (Balfour, 2014). Sexual health is one of the elements of health services need to be available for sex workers who confront abusive clients (Church et al., 2001). This finding implies apart from creating awareness and reducing individual level behaviors for HIV/AIDS prevention, there is a need of reducing risky environment for sex workers.

The women in our study reported that they experience physical violence from their clients, which ranges from minor physical health issues like pushing to severe attacks that lead to death. Consistent with past results from different studies (Cepeda & Nowotny, 2014; Dasgupta, 2021; Ditmore, 2014; Genemo & Tito, 2015; Hiwot & Yohannes, 2012; Nemathaga et al., 2017; Okal et al., 2011), sex workers reported experiencing abuse at the hands of their clients in various forms beating, stabbing, or hanging. Likewise, a study undertaken in four African countries revealed that all sex workers reported physical violence like being beaten by clients or threatened with firearms repeatedly (Bosa et al., 2015; Scorgie et al., 2013). Physical violence results in a lot of suffering which includes pain, disability or scars (which remind the study participants’ violence victimization), and psychological impacts like depression, anxiety, fear, and anger (Fuller, 2015; Steven Betts et al., 2013). In addition, being unable to return to work might have serious financial consequences for the victim (Fuller, 2015). Sex workers try to overcome the consequences of physical violence as fast as possible to hasten their return to work (Okal et al., 2011). In addition, participants also reported that police are not willing to hear their complaints. This implies that there is a need to regulate the system of government bodies like police, and treatment services are central to reducing the consequence of physical violence among sex workers.

Almost all sexual and physical violence among sex workers was accompanied by emotional/psychological violence. In the present study, nearly all the study participants reported that they experienced insult, humiliation, intimidation, and warnings from their customers, alcohol drinkers, and even their neighbors. They were also discriminated against in social relationships. On the other hand, psychological violence will contribute to depression and low self-esteem which has implications for the mental health of the women throughout the life course (Balfour, 2014; Nemathaga et al., 2017). Victims of violence experienced post-traumatic symptoms like helplessness, shame, self-blame, loss of memory, lack of confidence, self-hate, depersonalization, and depressive symptoms (Carlson et al., 2017; Nemathaga et al., 2017). Furthermore, commercial sex workers also reported social exclusion as psychological violence (Hiwot & Yohannes, 2012).

Although women were driven to commercial sex work to improve their economic circumstances, they experienced devastating economic violence. The current study identified economic violence like withholding, diminishing, and denial of extra payment, damaging one’s materials, and stealing money. Some customers force the woman to give payments back even after intercourse. Evidence revealed some clients of sex workers deny their payment after sexual intercourse and even steal their money (Hiwot & Yohannes, 2012). The sex workers accept the denial of payments as a coping mechanism to avert potential conflicts and physical violence. Women who engage in sex work do so because they are unable to find other employment due to financial challenges or family financial troubles. Additional studies showed that it is mainly due to a lack of economic prospects, several segments of the population have turned to sex work as a major source of income (Bucardo et al., 2004; Lim et al., 2019; Reed et al., 2010, 2022). However, economic violence diminishes the financial capacity of the woman to secure their daily expenses. One participant mentioned that “…there were times I spent without food throughout a day…”

Effectively managing and addressing experiences of violence plays a crucial role in minimizing the impact of trauma and facilitating the individual’s recovery (Nemathaga et al., 2017). In this research crying, returning the money back, physical attacks on the perpetrator, and seeking help from external persons were reported as coping mechanisms. While others decided to sell sex only during the daytime to reduce the violence. In Kenya for instance, sex workers assess safety issues, resist accompanying clients to unfamiliar areas, limit alcohol intake, use female condom, use physical force, and share stories about bad clients as a mechanism to reduce and cope with violence (Okal et al., 2011). Building friendships and solidarity with fellow sex workers and enhancing awareness about their rights were reported as coping mechanisms (Scorgie et al., 2013). In addition, a study in Bahirdar city identified being tolerant and arranging working hours as coping mechanisms to reduce violence (Hiwot & Yohannes, 2012).

Strength and Limitations

The strength of this study is that a qualitative study that explored the lived experiences of commercial sex workers from their own perspectives and experiences; it strengthens the existing knowledge of violence among sex workers. However this study is not free of limitations, first, due to the phenomenology nature of the approach, the study did not include the perspectives of institutions like police, legal, and other government bodies of the study subject. Second, the absence of data from perpetrators limits the ability to comprehend their motives for violence. Last, all the data collectors were males, which may influence the response of the participants.

Conclusion

Gondar city commercial sex workers experience sexual violence, physical violence including death, emotional violence including discrimination and they experienced economic violence by clients, friends, and neighbors, and structural violence. The study reveals a link between condom negotiation and violence among sex workers, and this puts them at risk of HIV and other STIs. As a result, existing health legislation and STI prevention initiatives must take into account the types and conditions surrounding the violence that puts women at risk. There should be a policy to make perpetrators legally accountable like other individuals. Overall to combat violence there should be a mechanism of government and NGOs or other stakeholders’ involvement to decrease the expanding issue of commercial sex work. Additionally, it emphasizes the importance of providing life skills to empower women, such as financial, domestic, survival, goal-setting, communication, relationship-building, boundary-setting, and problem-solving skills. These skills are mentioned as a means to help prevent or reduce the violence experienced by commercial sex workers. Finding alternative work is difficult for most women and needs supporters either from the government or other stakeholders. Further quantitative study is needed on the magnitude of violence and its forms as well as help-seeking among commercial sex workers in order to give generalization.

Supplemental Material

sj-pdf-1-sgo-10.1177_21582440251324724 – Supplemental material for “Many People Do Not Consider Us Human” Violence Against Commercial Sex Workers in Gondar City: A Phenomenological Study

Supplemental material, sj-pdf-1-sgo-10.1177_21582440251324724 for “Many People Do Not Consider Us Human” Violence Against Commercial Sex Workers in Gondar City: A Phenomenological Study by Habitu Birhan Eshetu, Amare Zewdie, Eshetu Girma, Ayenew Kassie, Asmamaw Adugna, Adane Nigusie and Simegnew Handebo in SAGE Open