Structural Violence in Health Care: Lived Experience of Street-Based Female Commercial Sex Workers in Kathmandu

Qual Health Res. 2017 Jan;27(2):191-203. doi: 10.1177/1049732315601665. Epub 2015 Aug 27.

Abstract

Thirty-five in-depth, semi-structured interviews were conducted with female, street-based, commercial sex workers in Kathmandu, Nepal. The framework of structural violence guided this study in identifying the structural context that impacts the female sex workers' lives and may cause harm to their health. Structural violence in health care was revealed through thematic analysis as (a) discrimination, (b) forced choice, and (c) limitations to health information sources. Lived experiences highlight how the sex workers engaged with structural limitations in health care access, services, and utilization. Structural violence conveys a message about who is entitled to health care and what a society emphasizes and expects regarding acceptable health behavior. Examining the structural violence highlighted how the sex workers negotiated, understood, and engaged with structural limitations in health care access, services, and utilization.

Keywords: Asia, South / Southeast; health care, access to; interviews, semi-structured; lived experience; sex workers.

MeSH terms

  • Adult
  • Female
  • Health Services Accessibility*
  • Humans
  • Interviews as Topic
  • Middle Aged
  • Nepal / epidemiology
  • Prejudice / psychology*
  • Qualitative Research
  • Sex Workers / psychology*
  • Sexually Transmitted Diseases / diagnosis
  • Social Stigma
  • Violence / psychology*