1. GENDER BASED VIOLENCE FACED BY SEX
WORKERS IN NAIROBI AND MOMBASA: A TALE OF
TWO CITIES IN KENYA
Margaret Njiraini, Learning Site Officer
NASCOP Technical Support Unit
19th June 2014
1

2. Background of Technical Support Unit
(TSU)
• Established to support NASCOP and its implementing
partners Key population Programs.
• Support: the scale of MARPs Programming
• Improve: Quality of MARPs program
• Monitor: Impact
• Main Goal is to Contribute to a reduction in HIV
incidence in Kenya.
• One strategy being used is to establish NASCOPs KPs learning sites
in Mombasa and Nairobi.

3. Background-
Violence and Sex work
• Sex work in Kenya is criminalized and largely lacks social
and moral sanction.
• Sex workers are harassed, stigmatized and
disempowered. Violence is a manifestation of stigma and
discrimination
• Evidence shows that violence has a direct and indirect
bearing on reducing key populations access to and use of
condoms, lubes, needles and services which can prevent
HIV

4. Intersection of HIV and Violence
Direct
• Rape (frequent and gang
rape)
• Coercion to have sex
without condoms (by gate
keepers, law
enforcement)
• Coercion in intimate
relationships
Indirect
• Fear of violence
discourages KPs to come
to places where
commodities or services
are available
• Constant experience of
violence leads to anxiety,
depression, loss of self
esteem and lower priority
to health
Source: Violence against sex workers and HIV prevention, Information series 3, WHO, 2005

5. PBS- in Nairobi and Mombasa
• Experience of violence against male and female sex
workers was studied in Mombasa and Nairobi
• The study used the polling booth survey technique which
is a group interview technique where individual responses
are unlinked and anonymous- The study was conducted
in the NASCOP learning sites in Nairobi and Mombasa
(implemented by SWOP, ICRH, BHESP and KESWA).
• Study period- September- October 2013

6. PBS Methods
• Members were separated
from each other in a polling
booth environment
• Each participant was given 3
boxes (Red, Green and
White) and a pack of cards
• Cards were numbered
corresponding to the
number of questions
asked
• Cards stacked in serial
order
6

7. PBS Methods
• Responses
• Card with the number
corresponding to the question
asked was into the Green box
if the response to the question
is YES
• Card was put into the Red box
if the response is NO
• Card was put into the White
box if the question is NOT
APPLICABLE
• Card was kept outside these
boxes if the participant does
not want to respond to that
question

8. PBS Method
• The moderator explained the PBS method with an
example and a practice session.
• Questions were read one by one
• The moderator had to:
• Make the exercise lively
• Ask each question clearly, slowly and loudly so that
every participant hears the question clearly, repeating
the question as required
• Use situations/stories while asking the question
• Use local terms
• Give sufficient pause, and not to hurry
8

9. PBS Method
• At the end of administering the
questions:
• Cards were collected separately:
the ones that were in the Green
boxes, the ones that are in Red
boxes and the ones that are in
the White boxes
• The number of cards in each box
were counted for each question
and tallies recorded in a
reporting form
• The group’s responses were
shared and discussed with the
participants
• Group discussion points were
documented.
9

10. Polling Booth Questions
• Only the questions that have a definitive YES or NO as
answers are suitable to be asked in PBS
• In the past 6 months, were you ever beaten or otherwise physically
forced to have sexual intercourse with someone even though you
did not want to?
• In the past 6 months, were you ever arrested or beaten up by
police, City Askaris, rowdy groups, etc, when you were doing sex
work or at a sex work spot?
10

11. Results of PBS for FSW and MSW,
Nairobi and Mombasa, 2013

12. Sample Size
Location FSW MSM
Mombasa 693 261
Nairobi 824 301
Total 1517 562

13. Experience of violence, by area, Nairobi
and Mombasa, FSW
27%
17%
53%
30%
0%
10%
20%
30%
40%
50%
60%
Nairobi Mombasa
% Ever forced to have sex in past 6
months
% Ever arrested/ beaten by police
and others in the past 6 months
22% Of the FSW population in both cities have been forced to have sex
while 32% have been arrested/beaten by police and others past six months.

14. Experience of violence, by spot type,
FSW Nairobi and Mombasa,
Nairobi
26% 27%
52%
54%
0%
10%
20%
30%
40%
50%
60%
Streets/ highway
& parks
Venues
% Ever forced to
have sex in past 6
months
% Ever arrested/
beaten by police
and others in the
past 6 months
Mombasa
20%
17%
43%
28%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Streets/ highway
& parks
Venues
% Ever forced to
have sex in past 6
months
% Ever arrested/
beaten by police and
others in the past 6
months

15. 18%
26%
24%
23%
0%
5%
10%
15%
20%
25%
30%
Nairobi Mombasa
ever forced to have sex in the past 6
months
ever arrested / beaten by police or others
in the past 6 months
While higher MSWs have been forced to have sex in the past 6 months in
Mombasa, more MSW in Nairobi experience arrest by law enforcement,
Experience of violence, by area,
Nairobi and Mombasa, MSW

16. Experience of violence, by spot type,
MSM/MSW Nairobi and Mombasa
Nairobi
25%
12%
28%
20%
0%
5%
10%
15%
20%
25%
30%
Streets/ highway
& parks
Venues
% Ever forced to
have sex in past 6
months
% Ever arrested/
beaten by police
and others in the
past 6 months
Mombasa
22%
46%
20%
42%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Streets/ highway
& parks
Venues
% Ever forced to
have sex in past 6
months
% Ever arrested/
beaten by police
and others in the
past 6 months

17. Conclusion
• FSWs in Nairobi reported a higher Violence incidence
(27% forced sex and 53% arrested) than in Mombasa
(17% forced sex and 30% arrested).
• Forced sex against MSW was slightly higher in Mombasa
(26%) compared to Nairobi (18%) though police violence
was similar.
• Generally Violence differed with typology of sex work
(venue vs street)

18. Using Evidence for Programming
• This evidence was used to design a programme for
violence prevention and response for sex workers in
Nairobi and Mombasa.
• The intervention includes
• Sensitisation of perpetrators
• Recruitment and training of paralegals
• Rights awareness among sex workers
• Medical, psychosocial and legal support at times of violence/
arrests

19. Recommendations
• Violence is a structural barrier to sex workers accessing
services and information
• HIV prevention programmes with sex workers need to address
this structural barrier and plan and implement violence
prevention and response mechanism
• Evidence on violence is needed to design intervention but also
to undertake advocacy with policy makers.

20. Thank you!