In Uganda’s fishing communities, sex workers encounter significant challenges, often enduring in silence. Their geographical isolation, societal stigma, and the neglect of traditional healthcare systems exacerbate their struggles, undermining their health, autonomy, and dignity. Persistent issues such as unsafe abortions, sexual violence, and inadequate access to comprehensive sexual and reproductive health (SRH) services are critical concerns that demand attention.
Research underscores the severity of these challenges.
- HIV Prevalence: The prevalence of HIV among sex workers in Uganda is reported at 37%, a stark contrast to the 5.4% prevalence observed in the general population of women aged 15 to 49.
- Unsafe Abortions: Unsafe abortions account for 28% of maternal deaths in Uganda, with sex workers disproportionately affected due to limited access to contraceptive options, coercive environments, and unsafe practices.
- Violence: The occurrence of physical and sexual violence remains alarmingly high. During a Musawo Session held at the Kigungu landing site, sex workers shared distressing accounts of abuse, including severe physical injuries and coercion into unprotected sexual encounters.
FMP recently launched the Reimagining Abortion Care and Pleasure for Sex Workers in Fishing Communities project, a three-year initiative dedicated to advancing sexual and reproductive health and rights of sex workers in Uganda’s fishing communities. .
Why is Pleasure a Game-Changer in Sexual and Reproductive Health for Sex Workers?
Centering pleasure in SRHR is a game changer for sex workers because it goes beyond just preventing harm—it creates a space for them to thrive. Pleasure is not a luxury; it’s a vital aspect of human well-being, and when we include it in SRHR, we acknowledge the full spectrum of a person’s sexual and reproductive life.
For sex workers, this approach shifts the focus from risk and survival to empowerment and joy. By embracing pleasure, we are actively dismantling the societal taboos that limit their ability to make empowered choices about their bodies and sexual experiences. This isn’t just about safer sex—it’s about recognizing that sexual satisfaction is a fundamental part of health. When sex workers are empowered to discuss and prioritize their pleasure, it strengthens their ability to negotiate safer practices, build healthier relationships, and reject coercion.
Furthermore, centering pleasure helps to break the silence that often surrounds the sexual experiences of sex workers. It allows them to talk openly about their desires, boundaries, and needs in a safe and respectful environment. This creates space for true consent to flourish, where mutual respect and autonomy take precedence over exploitation or shame.
When pleasure is integrated into SRHR, the focus is no longer on risk avoidance but on enhancing well-being, satisfaction, and overall life quality. It encourages a holistic approach to sexual health that affirms the rights of sex workers to enjoy sexual relationships that are not only safe but also fulfilling.
Incorporating pleasure also paves the way for a more inclusive SRHR framework that honors the diversity of sexual experiences. It acknowledges that sex workers, like anyone else, deserve access to sexual health services that respect their individuality and promote their happiness—not just their survival. It shifts the narrative from viewing sex work as inherently harmful to recognizing it as a legitimate form of labor that deserves dignity, autonomy, and full health rights.
Our approach is guided by three core principles:
- Education as empowerment: Providing sex workers with knowledge about safer sex, body literacy, and pleasure helps them negotiate safer conditions, make informed choices, and take control of their health.
- Advocacy through action: Training healthcare providers and peer mobilizers ensures that SRH services are not only accessible but also empathetic and inclusive, addressing the unique needs of sex workers.
- Shifting societal perceptions: By centering pleasure in SRH conversations, we challenge harmful stereotypes, encourage open dialogue, and promote respect and equality.
This project is more than a response to healthcare gaps—it is a movement to affirm the worth and rights of sex workers, reminding society that their well-being is just as important as anyone else’s.
We are grateful to Amplified Change for the partnership that is driving this transformative initiative. Together, we are advancing the Sustainable Development Goals (SDGs):
- SDG 3 (Good Health and Well-being): Reducing maternal mortality and improving access to SRH services.
- SDG 5 (Gender Equality): Empowering women and addressing gender-based violence and stigma.
- SDG 10 (Reduced Inequalities): Ensuring underserved communities receive the care they deserve.
A Future Where No One Is Left Behind
Sifa’s story—a 19-year-old coerced into unprotected sex, forced to resort to unsafe abortion methods, and left with life-threatening complications—underscores the urgency of our mission. Her experience is not unique, but a painful reminder of the realities faced by many sex workers in fishing communities.
Through this project, we aim to create a world where no woman feels abandoned, where every sex worker can access care that respects her autonomy, and where pleasure is recognized as a fundamental aspect of health and well-being.
By empowering sex workers, training healthcare providers, and challenging societal norms, FMP is not just addressing a healthcare crisis—we are building a movement. Together, we can reimagine what inclusive, respectful, and compassionate care looks like. Join us in creating a future where every person—regardless of their profession or circumstances—has the opportunity to thrive.
