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Estigma, violência física e violência sexual: tripla vulnerabilidade das mulheres trabalhadoras de sexo em Moçambique
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Introdução: As Mulheres Trabalhadoras de Sexo (MTS) são desproporcionalmente mais expostas a situações de violência devido ao estigma e a discriminação associado ao trabalho sexual, o que trás consequencias para tanto para a saúde, como para o bem estar e segurança destas mulheres. Existem poucos estudos em Moçambique que versam sobre a questão da violência física e sexual em MTS e a respectiva relacção com o Vírus da Imunodeficiência Humana (VIH), e considerando essa lacuna, o presente trabalho teve como objectivo analisar os factores relacionados ao estigma, violência física e violência sexual em MTS em cinco zonas urbanas de Moçambique.
Metodologia: Foi feita uma análise secundária de um inquérito observacional transversal em MTS implementado entre 2019-20, em que foi usada a técnica de amostragem por cadeia de referência (RDS – Respondent-Driven Sampling). Estimativas ponderadas agregadas foram calculadas para analisar o auto-reporte do estigma, da violência física e sexual. Recorreu-se ao teste Qui-quadrado para avaliar a associação entre as variáveis, e foi através da análise de regressão logística multivariada que o efeito das associações entre estas variáveis foi medido.
Resultados: Das 2.567 MTS que participaram do inquérito, 24,7% reportaram já ter sofrido estigma, 52,3% reportaram ter sofrido violência física e 37,9% violência sexual nos 6 meses anteriores ao inquérito. Ao analisar as características comportamentais constatou-se que, dentre as variáveis que apresentaram significância estatística, destacaram-se por ter maior impacto: ter tido mais de 7 clientes no mês anterior ao inquérito, aumentando em mais de 6 vezes as chances da MTS ser vítima de estigma (ORa=6,1; p <0,001), e o consumo drogas não prescritas, que demonstrou aumentar as chances da MTS sofrer tanto violência física como sexual em mais de 2 vezes (ORa=2,3; p <0,001; ORa=2,7; p <0,001). A prevalência do VIH demonstrou ter um papel importante, a medida que as MTS seropositivas tiveram maior chance de ser vítimas de violência física e sexual (ORa=1,2; p=0,006 e ORa=1,2; p=0,031, respetivamente).
Conclusão: O estigma e a violência são prevalentes entre as MTS em Moçambique. Os resultados demonstram que é necessário realizar intervenções estruturais, assim como reformas políticas para reduzir o estigma, garantir a segurança das MTS e melhorar o acesso das MTS à estas intervenções.
Abstract Introduction: Female Sex Workers (FSW) are disproportionately more exposed to violence due to the stigma and discrimination associated with sex work which has a direct impact on their health and safety. There are few studies in Mozambique that focus on stigma, physical and sexual violence among FSW, and considering this gap, this work aimed to analyse the factors related to stigma, physical violence and sexual violence FSW in five urban areas of Mozambique. Methodology: A secondary analysis was conducted using data collected from a cross-sectional survey implemented between 2019-2020 in FSW, using Respondent-Driven Sampling (RDS). Aggregate weighted estimates were calculated to analyse self-reported stigma and physical and sexual violence. Chi-squared test was used to analyse the association between variables, and multivariate logistic regression was used to measure the impact of the factors associated with stigma, physical and sexual violence. Results: Among 2.567 FSW that participated in the survey, 24,7% reported experiencing stigma, 52,3% physical violence and 37,9% sexual violence, in the 6 months prior to the survey. Having more than 7 clients in the month prior to the survey increased the odds of reporting stigma by more than 6 times (aOR=6,1; p <0,001), drug use increased the odds of suffering physical violence by more than twice ( aOR=2,3; p <0,001) and almost three times for sexual violence (AOR=2,7; p <0,001). FSW positive for HIV were more likely to be victims of physical and sexual violence (aOR=1,2; p=0,006 and aOR=1,2; p=0,031, respectively). To highlight that more variables were statistically significant, however these were the ones with the greatest impact. Conclusion: The high rates identified in this study, and the significant increase in the reporting of violence between 2012 and 2020, demonstrate that it is necessary to intervene to reduce stigma and violence, as well as to ensure the safety of FSW, putting an end to the endless cycle of violence and oppression.
Abstract Introduction: Female Sex Workers (FSW) are disproportionately more exposed to violence due to the stigma and discrimination associated with sex work which has a direct impact on their health and safety. There are few studies in Mozambique that focus on stigma, physical and sexual violence among FSW, and considering this gap, this work aimed to analyse the factors related to stigma, physical violence and sexual violence FSW in five urban areas of Mozambique. Methodology: A secondary analysis was conducted using data collected from a cross-sectional survey implemented between 2019-2020 in FSW, using Respondent-Driven Sampling (RDS). Aggregate weighted estimates were calculated to analyse self-reported stigma and physical and sexual violence. Chi-squared test was used to analyse the association between variables, and multivariate logistic regression was used to measure the impact of the factors associated with stigma, physical and sexual violence. Results: Among 2.567 FSW that participated in the survey, 24,7% reported experiencing stigma, 52,3% physical violence and 37,9% sexual violence, in the 6 months prior to the survey. Having more than 7 clients in the month prior to the survey increased the odds of reporting stigma by more than 6 times (aOR=6,1; p <0,001), drug use increased the odds of suffering physical violence by more than twice ( aOR=2,3; p <0,001) and almost three times for sexual violence (AOR=2,7; p <0,001). FSW positive for HIV were more likely to be victims of physical and sexual violence (aOR=1,2; p=0,006 and aOR=1,2; p=0,031, respectively). To highlight that more variables were statistically significant, however these were the ones with the greatest impact. Conclusion: The high rates identified in this study, and the significant increase in the reporting of violence between 2012 and 2020, demonstrate that it is necessary to intervene to reduce stigma and violence, as well as to ensure the safety of FSW, putting an end to the endless cycle of violence and oppression.
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Saúde pública Prostituição Violencia Moçambique