Dr. Michael Boah

Background Sex work in Ghana is deeply intertwined with economic hardship, criminalization, and social stigma, which subjects female sex workers (FSWs) to significant vulnerabilities. In Ghana, many FSWs, particularly immigrants, face compounded challenges, including physical and sexual abuse, police harassment, and discrimination, which are exacerbated by their migrant status. This study aims to address the gap in understanding the specific lived experiences of transnational FSWs in Ghana, with a focus on the intersection of gender, migration, and economic vulnerability. Methods This study utilized a qualitative phenomenological approach to explore the lived experiences of transnational FSWs in Ghana’s two largest cities, Accra and Kumasi. Participants were purposively selected through snowball sampling technique until thematic saturation was achieved, interviewing fourteen FSWs. In-depth interviews were conducted in English. Data collection took place in November and December 2024, with basic demographic data gathered at the beginning of each interview, and thematic analysis was employed to analyze the anonymized transcripts. Results Economic necessity was the primary driver behind migration and entry into sex work for FSWs, with many revealing that promises of legitimate employment often led to coerced involvement into the trade. Participants also reported high levels of violence, including physical assault, theft, and sexual coercion from clients, often in isolated locations. They also experienced harassment and exploitation by law enforcement, which compounded their vulnerability. Additionally, discrimination based on nationality also exacerbated their vulnerability, as foreign FSWs were often treated more harshly than their Ghanaian counterparts by clients, police, and the public. Conclusion This study’s findings highlight the urgent need for comprehensive policy reforms that address the root causes of migrant sex work, including better economic opportunities for women and the decriminalization or regulation of sex work to protect sex workers from the risks associated with its illegal status, such as police harassment, exploitation, and lack of legal protections.

Background The Acquired Immune Deficiency Syndrome (AIDS) pandemic has created a lot of devastation over the last four decades and continues to be a public health threat. Anti-retroviral treatment (ART), a group of medications that people who have been diagnosed with the Human Immunodeficiency Virus (HIV) infection take, has been shown to be efficacious and has significantly improved the fight against the disease. In Ghana, women carry a higher prevalence and incidence of HIV. The study’s objectives were to understand the experiences of women living with HIV/AIDS on ART and determine the barriers and enablers for ART uptake from the perspective of both the females living with HIV and their healthcare providers in the Upper East Regional Hospital of Ghana. Methods This was a qualitative study that used interviews to acquire data from women living with HIV on the perceived barriers and enablers for ART. The Upper East Regional Hospital in Ghana was the study site. We used a phenomenological approach to explore the lived experiences, perceptions, and meanings associated with ART among women. We collected data until we reached thematic saturation, interviewing a total of sixteen women living with HIV. We conducted a focus group discussion with nine healthcare workers providing care at the ART clinic. Data were analysed using thematic analysis. Results Women living with HIV and their healthcare providers viewed an environment that provided encouragement and support from healthcare workers and patients’ relatives, the ability to conceal HIV status, peer counselling, and the perceived benefits of therapy as enablers of ART uptake and medication adherence. The following were barriers to ART uptake and adherence: ill health, forgetfulness, long distances to ART clinics, cultural and spiritual beliefs, and fear of stigma. Conclusions Enablers of ART uptake should be expanded upon and encouraged so that women living with HIV/AIDS can access drugs in a timely and stress-free manner. On the other hand, the barriers identified can be addressed through education, the expansion of healthcare infrastructure, and the economic empowerment of women.