Understanding the relationship dynamics between female sex workers and their intimate partners in Kumasi, Ghana

Abstract

This report presents findings from a qualitative study examining vulnerability to HIV and the prevention needs of men involved in intimate relationships with female sex workers (FSW) in Kumasi, Ghana. The study was conducted by a collaborative team of researchers from Boston University’s Center for Global and Health and Development (CGHD), Kwame Nkrumah University of Science and Technology (KNUST), and FHI 360. It is the last of nine small qualitative studies conducted under the Operations Research among Key Populations in Ghana project designed to gather in-depth, personal information from members of key populations about their vulnerability to HIV and other threats to their health and well-being. This project was funded by the United States Agency for International Development Ghana in collaboration with the Ghana AIDS Commission (GAC). The findings will be used to strengthen harm reduction interventions for sex workers and their intimate partners. Intimate partners of FSW are a population of growing interest in Ghana, where interventions focused on sex workers and both their paying and non-paying partners are being implemented by FHI 360 and other local organizations with support from the GAC and USAID. In 2012 Boston University and KNUST conducted a qualitative study looking at the backgrounds, living conditions, vulnerabilities, and HIV prevention needs of young female sex workers in Kumasi. Most (22/24) of the young women participating in in-depth interviews reported having a boyfriend or intimate partner, and half reported either never or only sometimes using condoms with these partners (1). In addition, quantitative data from two previous integrated bio-behavioral surveillance studies (IBBSS) conducted in 2009 and 2011 provide critical data showing the degree to which these men and their female partners (both those involved in sex work and others) are highly vulnerable to HIV and other sexually transmitted infections. The specific objectives were to: explore the emotional, financial and other power dynamics within these relationships; describe the sexual behaviors and HIV knowledge and vulnerabilities of both partners; and document the perceived availability and accessibility of social support and health services.