Health Concerns and Access to Services: Female Sex Workers’ Experiences in Mumbai, India

Published date01 June 2019
Date01 June 2019
doi: 10.1002/wmh3.298
© 2019 Policy Studies Organization
Health Concerns and Access to Services: Female Sex
WorkersExperiences in Mumbai, India
Marissa Kaloga , Sharvari Karandikar, Lindsay B. Gezinski, and
Rebecca J. McCloskey
Female sex workers (FSWs)in India experience unmet healthcare needs due to numerous barriers to
care. The objectivesof this study were to (i)explore the health concerns amongFSWs in Kamathipura, a
redlight district of Mumbai, India; and (ii)understand their experiences using healthrelated services
and resources. This qualitative study used indepth, semistructured individual interviews with 15
FSWs recruited usingsnowball sampling. Data analysis consisted of reading transcriptions line by line,
identifying themes, and coding categories. A matrix of health concerns and identified resources were
created to examine relationships. Participants identified numerous health concerns. Six thematic
categories emerged, encompassing all health concern codes: communicable disease, nutrition, substance
abuse, reproductive health, mental health, and physical violence.Participants reported varying levels of
availability ofhealth services; additionally, their basic health needs exceeded resource availability. FSWs
have vital health concerns that go untreated. Current health care and social service funding and
interventions are insufficient to meet the needs. Healthcare services must be expanded across all
identified health categories and FSWs informed of their existence. Furthermore, prevention and
intervention programs, with support from both nonprofits and government, must be prioritized to
address the basic food and safety needs of FSWs.
KEY WORDS: female sex workers, health, India
Mumbai is Indias financial center and largest city, with a population of over
twenty million people. It is home to the wellknown redlight area of Kamathipura,
comprised of approximately five thousand sex workers (Banerjee, 2017)engaging
in both brothelbased and streetbased sex work. Women and girls are frequently
sold into prostitution in this district without their knowledge, either by a friend,
acquaintance, or family member (Karandikar, Gezinski, & Kaloga, 2015),an
experience often accompanied by physical violence (Silverman et al., 2007). The
majority of sex workers in Kamathipura initially enter into sex work when they are
trafficked as minors from other states in India and from neighboring countries such
as Nepal and Bangladesh (Gezinski & Karandikar, 2013; Office to Monitor and
Combat Trafficking in Persons [OMCTP], 2017), and are initially kept inside
brothels with little access to the outside world (Karandikar et al., 2015). Cut off
from family networks and linguistically isolated, these women and girls live in the

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