SA sex workers' nightmarish mental lives exposed
New study reveals a shocking picture of mental illness fraught with violence, alcoholism and hunger
An international study into hundreds of South African sex workers has laid bare the horror of how many suffer from mental illness, including post-traumatic stress disorder (PTSD).
The Plos One study, which was released on July 5, looked at 508 sex workers who work in Soweto, outside Johannesburg. Of those, 16 were immigrants and all but two were black.
The research found that 74% had not completed school, 87% had been pregnant with 18% reporting the death of a child. Researchers found that nearly two-thirds regularly went hungry, with only 14% reporting that they had never been the victim of violence.
More than 50% of those surveyed were binge drinkers.The research, conducted over seven months, aimed to understand the prevalence of depression and PTSD and the risk factors among female sex workers.
The findings, said the authors, highlighted the sizable burden of treatable mental health conditions among Soweto’s sex workers, and “the urgent need to design and integrate services geared to the mental health needs for this population”.
The study showed that 68.7% (348) of those surveyed suffered from severe depression, with 39.6% (201) suffering from PTSD; 166 suffered from both PTSD and depression.
Funded by the Medical Research Council, the authors said mental health among sex workers in SA had infrequently been studied.
“This is of importance given their high exposure to violence and that sex work in South Africa is criminalised. This results in high levels of discrimination, a driver of mental health concerns, being perpetrated against sex workers.
“A 2017 study of 155 sex workers attending a support group in KwaZulu-Natal found that 78.4% suffered from depression and anxiety while 80% engaged in binge drinking.”
The study reveals that in India, 39% of sex workers suffer from depression, while the figure is 82.4% in Nepal.Studies in Australia and Israel, say the authors, reveal that 17% and 31% of those countries’ sex workers suffer from PTSD respectively. In Switzerland, similar research showed that 50.3% of sex workers suffered from some form of mental health disorder.
“Being a migrant sex worker increases the risk of mental health concerns by almost nine times, while violence increased the risk by three times,” reads the study.
The authors said research had shown that approximately 16.5% of South Africans suffer from PTSD.
Those who took part in the survey were asked questions about whether they had felt suicidal, had experienced violence, suffered childhood trauma, whether they had recurring thoughts or memories of an event, and if they felt jumpy or got a fright easily when thinking about a traumatic event.
“Our findings demonstrate the significant burden of mental illness among female sex workers. Our findings show that more than two-thirds in Soweto suffer from symptoms suggestive of severe depression, and more than a third suggestive of PTSD.”The authors said 10% of those surveyed had either had suicidal ideas or attempted suicide.
“In South Africa mental health is a largely neglected public health concern. Our findings highlight the burden of vulnerability for female sex workers, who are exposed to poor living and working conditions while being afflicted with a serious burden of mental health conditions.
“There is limited availability of mental health services in South Africa. The pervasive nature of violence in South Africa, particularly among this population, and the lack of political will to address this will make sustaining mental health a challenge.”