Health information seeking practices of sex workers in Kampala City, Uganda

Abstract

Sex workers in Uganda, particularly those operating in Kampala City, face heightened vulnerability to HIV/AIDS and other sexually transmitted infections (STIs) due to entrenched structural challenges, including systemic stigma, criminalization, social marginalization, and exclusion from formal health services. Although sex workers demonstrate notable resilience through the use of peer networks and community support systems, there remains limited empirical evidence on how they seek, access, evaluate, and use health information within such a hostile and restrictive environment. This study therefore examined the health information-seeking practices of sex workers in Kampala City with the aim of proposing strategic, context-sensitive interventions to enhance equitable access to and utilization of reliable, stigma-free health information. Specifically, the study sought to: examine the health information needs of sex workers; identify the key sources and channels through which sexual and reproductive health information is accessed; determine the challenges affecting access to health information; and propose strategic interventions to improve the health outcomes of sex workers in Kampala City, Uganda. Anchored in the Everyday Life Information Seeking (ELIS) theory, the study adopted a qualitative case study research design. Data were collected between 2022 and 2025 through focus group discussions involving 18 female sex workers, in-depth interviews with healthcare providers and allied health professionals, and document reviews guided by the READ (Readying, Extracting, Analyzing, and Distilling) approach. Purposive and convenience sampling techniques were employed to ensure representation from diverse sex work hotspots across Kampala’s central divisions. The collected data were analyzed thematically in alignment with the study objectives. The findings revealed that sex workers primarily sought health information related to HIV and STI prevention and treatment, family planning, safe sex practices, mental health and psychosocial support, and access to non-discriminatory healthcare services. Peer networks, community-based organizations, pharmacies, drop-in centers, and emerging digital platforms were identified as key sources of health information; however, the reliability, accuracy, and consistency of information varied considerably across these sources. Channels of access included informal word-of-mouth communication, mobile health outreach services, and social media platforms, with anonymity, confidentiality, and trust strongly shaping information-seeking behavior. Nonetheless, significant barriers to health information access were identified, including stigma and discrimination within health facilities, fear of arrest and legal repercussions, financial constraints, low literacy levels, misinformation circulating within peer networks, and limited trust in formal health systems. These barriers often compelled sex workers to rely on informal or unregulated information sources, thereby increasing their vulnerability to adverse health outcomes. The study concludes that while community-based and peer-led initiatives play a critical role in facilitating access to health information among sex workers, persistent structural and systemic barriers continue to undermine their effectiveness. To address these gaps, the study recommends integrated and rights-based interventions, including the decriminalization of sex work, expansion of sex-worker-friendly and confidential health services, strengthening of peer education and outreach programs, strategic use of digital health technologies for discreet information dissemination, and targeted capacity-building and sensitization of healthcare providers. These recommendations align with Uganda’s National Development Plan IV, the National HIV and AIDS Strategic Plan, and the United Nations Sustainable Development Goals particularly Goal 3 (Good Health and Well-being) and Goal 10 (Reduced Inequalities) and contribute to broader national and global efforts toward health equity, social inclusion, and universal health coverage.