Occupational Health and Safety among Female Commercial Sex Workers in Ghana: A Qualitative Study

Round 1

Reviewer 1 Report

The discussion segments of this paper are well written and clearly point out the risks involved in sex work.  The research for this paper is not complex and the report of  the research  fairly brief.

The Methodology

A relatively small sample was interviewed and observed.  A bigger sample size is usually more convincing.  The authors should explain how the 19 women who agreed to be interviewed and observed were selected?  Did they select every woman who agreed to be interviewed or observed? What proportion of those asked to participate agreed?  How were the observations carried out?  Did the observers keep field notes? How were the findings of the observations analyzed? 

The paper is well written and it is an important topic, especially in relation to the spread of STIs. The author's suggestions about what is needed to reduce the risks related to sex work are good and lead us to the next steps of research in this area. Given the risks involved related to poverty and violence what will motivate sex workers to mobilize and empower themselves to prevent infection? How do we eliminate the stigma attached to sex work?

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

The paper entitled “Occupational Health and Safety among Female Commercial Sex Workers in Ghana: A Qualitative Study”, aims to d analyze the occupational health and safety risks among female sex workers in the Greater Accra Region of Ghana to assist public health practitioners, health ministries, researchers, and medical officers in creating interventions for the women engaged in sex work. Researchers interviewed 19 female commercial sex workers while 50 female commercial sex workers were observed and engaged in informal conversations. According to the authors, fieldwork with female sex workers was conducted over a period of two months. However, they do not say when (1 year ago, two years ago?).

I would like to underline two features of the fieldwork. Interviewees were not provided with an economic incentive, and interviews were conducted “in situ”. In my opinion, these features increase the validity of the results. Most researchers doing fieldwork with sex workers offer them an economic incentive. This economic incentive is a small compensation for their time; however, not receiving an economic incentive also means that interviewees were genuinely interested in the study. On the other hand, conducting interviews “ex situ” is safer and easier than conducting interviews “in situ”. But, conducting fieldwork “in situ” provide researchers with a deeper understanding of the subject under study. On the other hand, researchers used “verbal consent” and not “written consent”. This is also important because in an issue as delicate as prostitution written consent is excessively intrusive.

This research provides important information to create interventions for women engaged in sex work. The authors conclude that if sex workers were provided with another means of work or if they received alternative financial assistance, they would quit prostitution. I think that this result derives from the sample studied: women between ages 25 and 50 (average 35.3). Sex work is a kind of work that pays better to younger workers. Sex workers are usually younger than in the sample studied, and younger sex workers usually do not want to quit prostitution to take a much poorly retributed job. For example, studies conducted in Mexico indicate that younger sex workers would be able to quit prostitution only if they were offered a job offering them a similar income. In the case of women 35.3 years on average, their income from prostitution is not much higher than the income from another means of work, therefore they would like to change prostitution to another job.

Therefore, the authors must consider that opinions from sex workers 35.3 years old on average may differ from younger sex workers, and in sex work younger women are predominant.

 

Finally, the authors’ references are not up to date. The authors should include more up to dated references, especially from papers published in the last five years.

Author Response

Please see the attachment

Author Response File: Author Response.docx