HIV and Population Mobility BEHAVIOURAL STUDY REPORT HIV VULNERABILITY AMONG FEMALE SEX WORKERS ALONG GHANA’S TEMA-PAGA TRANSPORT CORRIDOR 1 ACKNOWLEDGEMENT The primary data for this study on HIV vulnerability among female sex workers along Ghana’s Tema‐ Paga transport corridor was successfully collected during November and December 2011. The efforts of a number of individuals who were involved in the study are hereby acknowledged. We are grateful to UNAIDS for funding this study through the UNAIDS Supplemental Programme Acceleration Fund (PAF) for support to country level action to implement the agenda for accelerated country action for women, girls and gender equality and AIDS. We are particularly thankful to Dr. Léopold Zekeng, UNAIDS Country Coordinator, Ghana and Jane Okrah for their active support and involvement in the project. We would like to acknowledge the support of the Ghana AIDS Commission, the West African Program to Combat AIDS and STI Ghana (WAPCAS) and Management Strategies for Africa (MSA) for their involvement at all stages of this study. We thank all the experts who participated in a series of consultations that were organized to prepare research tools; undertook training of the interview teams; planned data analysis; prepared sampling method and sample size calculation; prepared questionnaires and the tabulation plan for the report. We are grateful to the research consultant Mr. Abraham Nyako Jr. and his team. We are also grateful to Mr. Anthony Amuzu Pharin of the Ghana Statistical Services (GSS) for his support in the statistical aspect of the study as well as generation of the statistical tables. We are very thankful to Mrs. Comfort Asamoah‐Adu, Mr. Kofi Mawuena Diaba and the WAPCAS interview team and supervisors for their efforts and dedication in collecting primary data from the participants. We convey special thanks to the participants of this study who, without hesitation, gave their time and narrated their experiences and views regarding their vulnerability to HIV infection in the context of mobility and migration. Special thanks to Dyane Epstein, IOM Ghana Chief of Mission for overall guidance and encouragement. 2 REPORT CONTRIBUTORS The IOM Research Team 1. Dr. Aden Guliye 2. Ms. Valentia Amados 3. Dr. Abena Asante 4. Dr. Jean Francois Aguilera The MSA Research Team 1. Mr. Abraham Nyako Jr. 2. Mr. Frank Oye The GSS Consultant 1. Mr. Anthony Amuzu Pharin The opinions expressed in the report are those of the authors and do not necessarily reflect the views of the International Organization for Migration (IOM). The designations employed and the presentation of material throughout the report do not imply the expression of any opinion whatsoever on the part of IOM concerning the legal status of any country, territory, city or area, or of its authorities, or concerning its frontiers or boundaries. IOM is committed to the principle that humane and orderly migration benefits migrants and society. As an intergovernmental organization, IOM acts with its partners in the international community to: assist in meeting the operational challenges of migration; advance understanding of migration issues; encourage social and economic development through migration; and uphold the human dignity and well‐being of migrants. Publisher: International Organization for Migration, Ghana House 10, Plot 48 Osu‐Badu Road/Broadway Airport West Accra Ghana Tel: +233.302.742931 Email: [email protected] Internet: http://www.iom.int/cms/west‐africa © 2012 International Organization for Migration (IOM) All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. Suggested citation: International Organization for Migration (IOM), Ghana. Behavioural Study of Female Sex Workers along Ghana’s Tema‐Paga Transport Corridor, 2012. 3 TABLE OF CONTENTS ACKNOWLEDGEMENT ................................................................................................. 2 TABLE OF CONTENTS .................................................................................................. 4 TABLES .............................................................................................................................. 6 ABBREVIATIONS ............................................................................................................. 7 EXECUTIVE SUMMARY ................................................................................................. 8 Background ............................................................................................................................................................. 8 Objective ................................................................................................................................................................. 8 Methods ................................................................................................................................................................... 8 Results ..................................................................................................................................................................... 9 Conclusion ............................................................................................................................................................ 10 Recommendations .............................................................................................................................................. 10 1 BACKGROUND AND INTRODUCTION ............................................................ 11 1.1 Literature review ........................................................................................................................... 11 1.2 Situational Analysis ........................................................................................................................ 13 1.3 Rationale for the study ................................................................................................................. 14 1.4 Aims and objectives ...................................................................................................................... 14 2 METHODOLOGY .................................................................................................... 14 2.1 Sampling methodology .......................................................................................................... 14 2.1.1 Study population and operational definition .............................................................................. 14 2.1.2 Study Site selection .......................................................................................................................... 15 2.1.4 Sampling ...................................................................................................................................................... 16 2.2 Data Management ................................................................................................................... 17 2.3 Analysis Strategy ...................................................................................................................... 17 2.3.1 Variables of interest ......................................................................................................................... 17 2.3.2 Statistical methods ............................................................................................................................ 17 2.4 Ethical approval ........................................................................................................................ 18 3 RESULTS ................................................................................................................... 18 3.1 Basic characteristics of the study population: ............................................................ 18 3.1.1 Study site and FSW type ................................................................................................................. 18 3.1.2 Reasons for entry into, continuation with and intention to stop sex work ....................... 19 3.1.3 Demographic characteristics ......................................................................................................... 20 3.1.4 Social characteristics ........................................................................................................................ 20 3.1.5 Sexual behaviours ............................................................................................................................. 21 3.1.6 Income ................................................................................................................................................. 23 3.1.7 HIV knowledge, risk perceptions and condom use perception ............................................ 24 3.2 Mobility characteristics ......................................................................................................... 25 3.2.1 Movements ......................................................................................................................................... 25 3.2.2 Most recent movements ................................................................................................................. 26 4 3.2.3 Popular destinations in Ghana ....................................................................................................... 26 3.3 Similarities and