· Commercial sex work or prostitution exists in Kampala city and quite many young women are involved in this trade as a means of survival.
· Many young women are led into sex work due to adverse socio-economic and demographic factors that make them especially vulnerable to prostitution. Most notable of these are unemployment and lack of financial support for themselves and their dependents.
· Awareness about STDs and HIV/AIDS among sex workers was high, including awareness about the various protective options.
· Most sex workers were engaged in risky sexual behavior through unprotected sex and multiple sexual relationships. Consequently, sexually transmitted infections were highly prevalent among the prostitute community.
· Knowledge about the correct use, storage and disposal of condoms was still lacking, although condoms were readily available and accessible to the sex workers through various outlets.
· Although many sex workers sought to protect themselves by using condoms, economic, psychosocial and behavioral factors among sex workers prevented consistent and sustainable use of condoms. On many occasions, clients, not prostitutes, largely contributed to the failure of condom use and drove sex workers into unprotected sex.
· Sex workers perceived that they are at a high risk and vulnerable to HIV/AIDS infection and were aware of risk reduction options. However, risky behavior that permitted continued disease transmission still persisted among sex workers and their clients.
· Many sex workers were gradually adopting behavior change in the wake of the deadly AIDS scourge through partner reduction and condom use.
· Government, policy makers and program providers should recognize sex workers or prostitutes as a social group within the population that derives its existence from the complex demographic, socio-economic and political phenomena that our society experienced, and who need services and development programs to meet their special needs.
· Young women are driven into sex work by complex socio-economic, political and socio-demographic factors. There is a need to appreciate these, and create advocacy into measures that protect the girl-child from these adverse factors that make them especially vulnerable to sex work.
· The problem of prostitution is integral to the problem of the spread of STD and HIV/AIDS since prostitutes are potentially a "reservoir" of infection to the general public. Therefore, sexually transmitted infection programs need to address the special needs of sex workers that drive them into risky behavior when they are well aware of the potential risks involved.
· Sex workers' clients are men from all walks of life and are part of the general public. Many of them have been visiting prostitutes for several years and several times, and also visited several prostitutes. They are thus also at risk being infected by HIV/AIDS. There is a need to study factors that motivate these men to visit prostitutes. There is also a need to establish the knowledge, attitude and sexual behavior of the clients related to STD and HIV/AIDS in order to come up with appropriate interventions since many of these have been reported to be averse to using condom.
· There is a need to incorporate efforts geared towards income generating activities in interventions among sex workers. This will, in the first instance, raise their bargaining power while negotiating for safer sex with clients. Ultimately, this will provide them with alternative income to sex work if they opt to abandon the sex trade.
· Many sex workers cannot fully benefit from the educational programs about HIV/AIDS since they are either illiterate or semi-literate. Therefore, STD and HIV/AIDS interventions among sex workers should include adult and functional literacy to improve the benefit of the target population.
· Condoms have been observed to play a big role in reducing the risk of HIV infection among sex workers. There is a need to increase awareness on the importance of consistent condom use among sex workers and their clients. There is also a need to introduce and emphasize the female condom, which does not require the cooperation of the clients since many have been reported to be reserved about using them.
· The role of peer educators as a vital human resource in passing on information and education about STD and HIV/AIDS needs to be exploited. Many sex workers are in constant contact with their peers and freely pass on information to one another, which they deem necessary for their survival. In many programs, use of peer educators is cost-effective as many of these are often volunteers and are within the reach of the target population most of the time.
