Why policy action should focus on the vulnerable commercial sex workers in Uganda during COVID-19 fight

Abstract

According to the Ugandan Ministry of Health, as of 24th June 2020, Uganda had registered a total of 797 cases of COVID-19. Two months prior, a majority of the positive cases in Uganda had been linked to being spread by long-distance truck drivers who drove into Uganda from Kenya and Tanzania. These neighboring countries had registered more COVID-19 infections and mortality. Seeing as the sex workers in Uganda are popularly found at border points where they interact with truck drivers they were a key target in reducing community spread. In response, the Ministry of Health employed a self-proclaimed sex worker and Kampala city socialite to cast a commercial break advertisement as a health promotion measure. She warned girls at the Ugandan borders to avoid truck drivers to keep the nation free of COVID-19. This move went beyond the discrimination that sex workers in Uganda face to show the importance of such a marginalized group in the community spread of infectious diseases like COVID-19. Building from Uganda´s previous experience with HIV/AIDS, unempowered sex workers are at a higher risk for transmission with a 37% infection rate compared to 9% in the general population. Some of these workers are sometimes forced to ignore regulations geared towards infection control as their ‘daily bread’ depend on the trade. During the COVID-19 times, their plight is worsened by the inability to afford safe sex by using condoms and some of their customers preferring not to use protection. Likewise, the majority of sex workers are illiterates as seen by only 53% of them having attained primary education in contrast to 73% in the general population. Consequently, such vulnerable illiterate sex workers fail to fully comprehend the various health measures imposed by policymakers, and their bargaining power for safer sex is subdued.