Reviewer's report
Title:"I do what I have to do to survive": An ethnographic investigation into the
perceptions, experiences and economic considerations of women engaged in
sex work in Northern Namibia
Version: 1Date:23 February 2011
Reviewer: Melanie Rusch
Reviewer's report:
Major Compulsory Revisions
Introduction – In paragraph 2, the introduction points out the lack of success of
education/behavioral programs on their own, but does not discuss other
strategies that have been used to overcome this problem, which is not new
(client interventions, structural interventions). Paragraph 3 highlights the dearth
of research regarding sex work in Namibia, and especially in rural areas. After
reading the results, it seems that the majority of participants were informal sex
workers – providing a brief explanation here (or addressing this in the discussion)
of the difference would help develop the context of sex work in this study, and
would increase the importance of this research in identifying barriers among sex
workers that may not benefit from existing programs that are tailored for more
formalized contexts (e.g. venue-based interventions).
Methods – As an ethnographic study, the aims statement (introduction, para 4)
and objective statement (methods para 3) seem very specific, and don’t mention
experiences with the BCC program, which seems to be a large part of the study.
Results – There is no description of the context of sex work in this area. Some
description of the participants and the characteristics of sex work in this region
would help frame the themes that arise from the interviews.
Discussion – Although the theme of economic power/independence was clearly
important, the discussion focuses mainly on this and leaves out discussion of
other themes that were of interest. For example, the theme of hoping for
love/family (results, para 12), from the quotes provided, does not necessarily tie
directly to money; however, no discussion of the other potential meanings
(wanting a family, social capital of having a weathy man’s child) are discussed. In
addition, in paragraph 7, it is pointed out that community members view
negatively programs aimed at empowering women, to the extent that a peer
educator states that men may become ‘angry’ if they feel a program is doing this.
This point needs to be brought into the discussion, especially in paragraph 4
where the authors suggest implementing empowerment programs.
In the second paragraph of the discussion the authors indicate the acceptability,
but overall ineffectiveness of the current peer-education programs among the
women. The authors focus the discussion of why this may be on the 3 E's, but
could provide more discussion on the other barriers (or how the 3 E's will also
overcome these) which were touched on in the results, such as client
perspectives regarding condom use and larger community acceptability of such
programs.
Minor Essential Revisions
The authors list an affiliation with the Namibian AIDS Coalition, but no author is
associated with this affiliation.
"Response bias", indicated as a limitation in the discussion, paragraph 6 would
be more appropriately labeled "Social desirability bias".
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests