By Kabuye Ronald
In the heart of Uganda’s bustling capital, Kampala, a wave of change is taking root in an often-marginalized community: the sex workers. Once vulnerable to exploitation, disease, and misinformation, many are now champions of safe sex practices, thanks to an inspiring and relentless campaign led by the Women’s Organization Network for Human Rights Advocacy (WONETHA) and other sex reproductive health organisations.
Uganda has long battled with a heavy HIV burden. As of 2018, an estimated 1.4 million Ugandans were living with HIV, with a prevalence of 5.7% among adults aged 15 to 49. Women bear the brunt of this epidemic, with 8.8% affected compared to 4.3% of men. The situation is even graver for sex workers, among whom HIV prevalence is nearly 12 times higher than in the general population. The risks they face are exacerbated by poverty, limited access to education, and exposure to violence and stigma. But change is happening, and it’s coming from within.
WONETHA, founded in 2008, emerged in response to the discrimination and human rights violations faced by sex workers in Uganda. With a focus on empowering women, advocating for health rights, and dismantling the stigma around sex work, the organization identified a critical gap in knowledge and practice the inconsistent or absent use of condoms.
Sarah Kisakye Mpooma, an advocacy officer at WONETHA, is at the forefront of this transformation. “As sex workers, condoms are our capital,” she states emphatically. “Our colleagues at fishing sites and landing areas were risking their lives for extra money. We knew we had to act.”
WONETHA initiated mass sensitization campaigns across five key regions Rwenzori, Eastern, West Nile, Mubende, Masaka targeting sex workers with education and free distribution of condoms. What started as awareness workshops quickly turned into a lifeline for thousands.
According to a 2016 survey conducted in Kampala slums, only 25% of sex workers reported always using condoms, while others cited reasons such as client refusal, financial incentives for unprotected sex, or familiarity with the client. Some sex workers were unaware of how to properly use a condom, even resorting to using teeth or scissors to open them.
“We realized many women lacked knowledge, not just about the ‘why’ but also the ‘how’,” Kisakye explains. “We included practical demonstrations in our trainings and emphasized self-assertiveness because knowing your right to say no is power.”
Today, WONETHA distributes two to three million condoms monthly, ensuring that each sex worker receives an adequate supply depending on the region and demand. The condoms are sourced through Ministry of Health channels and donor partners. However, distribution isn’t without its hurdles.
“Our biggest challenge is transportation,” Kisakye says. “We operate with a single van. Sometimes we get urgent requests from multiple regions, and we can’t meet the need in time. We’re calling on the government and donors to support us with more vehicles and to stock all health centers with free condoms accessible to sex workers.”
Skylar, a sex worker in Kibuye, Makindye Division, speaks with pride and relief. “Before, we had to buy our own condoms, which was costly. Many didn’t bother and got infected. Now, we get them for free along with education. We’re saving lives.”
Anitah, a mother of four and seasoned sex worker, shares a poignant reflection: “I joined this work in 2018 to take care of my kids after being abandoned. I’ve seen friends die because of unprotected sex. I can’t risk it. I insist on condoms with every client.”
Hadijah, also from Makindye, adds that experienced sex workers have now taken on a mentoring role. “We educate new girls. Many are very young and naïve some as young as 15 or 16. We tell them the truth: no amount of money is worth your life.”
Beyond HIV prevention, condom use has been crucial in reducing unintended pregnancies, a major challenge among Ugandan women. A 2021 study by Makerere University’s PMA project found that 46% of pregnancies were unintended, with the majority among rural women and teenagers aged 15-19.
In the context of sex work, an unplanned pregnancy often compounds the cycle of poverty and vulnerability. “Condoms protect us not just from diseases but from pregnancies we can’t afford,” Skylar affirms.
WONETHA’s model of peer-led advocacy is proving powerful. By placing knowledge and resources directly into the hands of sex workers, they are reshaping narratives around their work from one of exploitation to one of empowerment, health, and dignity.
As Uganda continues to grapple with the HIV epidemic, sex workers, once perceived solely as part of the problem, are now undeniably part of the solution not just protecting themselves, but protecting the wider community.
