Evidence map›Paper›PMID 40253351›Full record

ArticleBMC women's health2025

Crossroads of choice: a qualitative study of the factors influencing decisions to transition from sex work among women engaged in sex work in Southern Uganda.

Jennifer Nattabi, Ozge Sensoy Bahar, Josephine Nabayinda, Proscovia Nabunya, Joshua Kiyingi, Samuel Kizito, Flavia Namuwonge, Edward Nsubuga, Susan S Witte, Fred M Ssewamala

Abstract read
In one paragraph

Article in BMC women's health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Jennifer NattabiInternational Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.
Ozge Sensoy BaharInternational Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, United States of America. Ozge.sensoybahar@wustl.edu.
Josephine NabayindaInternational Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.
Proscovia NabunyaInternational Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.
Joshua KiyingiDepartment of Medicine, Division of Prevention Science, University of California San Francisco, 550 16th Street, 3rd Floor, UCSF Mail Code 0886, San Francisco, CA 94158, USA.
Samuel KizitoInternational Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.
Flavia NamuwongeInternational Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.
Edward NsubugaInternational Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.
Susan S WitteSchool of Social Work, Columbia University, New York, United States of America.
Fred M SsewamalaInternational Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWomen engaged in commercial sex work (WESW) are exposed to behavioral, biological, and structural factors that exacerbate their risk of HIV infection and other sexually transmitted infections. While commercial sex work may appear voluntary, WESW are more likely to be constrained to selling sex due to limited viable alternatives. To effectively support this vulnerable group of women, it is critical to understand factors that facilitate and impede their decisions to transition from sex work into other careers or jobs. The current study explored women's decision to transition from sex work into other careers or jobs.

methodsFace-to-face semi-structured in-depth interviews were conducted with 53 WESW aged 20-47 enrolled within the larger Kyaterekera study, a randomized clinical trial (N = 542) implemented in 19 geographical hotspots in the Southern region of Uganda. Participants were selected based on their level of intervention attendance (high/medium/low attendance) during the 12-month follow-up (Time 2). The interviews were conducted in Luganda the widely spoken language in the study area to explore the factors influencing women's decisions to transition from sex work to other jobs or careers. The main interview question used for this study was, "What are some of the factors that may influence whether you would transition from sex work to other jobs or vocations?" All interviews were audio-recorded, transcribed verbatim, and translated into English. Thematic analysis in Dedoose software was used to analyze the data.

resultsParticipants reported three primary types of decisions, including considering leaving sex work, deciding to leave, and staying in sex work. The emerging themes from the interviews were categorized into individual and structural level facilitators and barriers to transitioning out of sex work. Individual-level factors included issues of stigma, discrimination, and aging as factors that facilitated women's decision to leave sex work. At the interpersonal level, physical and sexual violence was noted as a reason to leave sex work. At the structural level, stigma and discrimination (from community members) were identified as facilitators to leaving sex work. Income-related factors were identified mainly as barriers to leaving sex work.

conclusionOur study highlights the complex decision-making processes among WESW as they navigate transitions to alternative jobs or careers. By advocating for multifaceted interventions and policies tailored to the diverse challenges faced by WESW, our study contributes to a more informed approach to supporting their transition out of sex work.

Indexed as

Career ChoiceChoice BehaviorDecision MakingSex WorkSex WorkersAdultFemaleHIV InfectionsHumansInterviews as TopicMiddle AgedQualitative ResearchSocial StigmaUgandaYoung AdultCommercial sex workSub-Saharan AfricaTransition from sex workUgandaWomen engaged in sex work

Identifiers

PMID40253351
PMCPMC12008991

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.