Strengthening interventions to support the sexual and reproductive health and wellbeing of young women involved in sex work amid conflict and distress migration in Ethiopia

Glob Health Action. 2026 Dec;19(1):2606431. doi: 10.1080/16549716.2025.2606431. Epub 2026 Feb 4.

ABSTRACT

BACKGROUND: Amid growing global recognition of the importance of young people’s sexual and reproductive health and wellbeing, an intervention to support peer-based comprehensive sexuality education (CSE) for young women involved in sex work in Ethiopia was implemented in 2020. Since 2018, conflict has driven an upsurge in distress migration by young women to some intervention sites.

OBJECTIVE: This article explores the experiences of young women involved in sex work alongside peer facilitators to understand the strengths and limitations of the CSE intervention and the broader impacts of conflict and distress migration, in order to identify implications for future interventions in Ethiopia.

METHODS: The article draws on qualitative findings from implementation research undertaken with young women involved in sex work (n = 60) and peer facilitators (n = 15) in Addis Ababa, Bahir Dar and Hawassa cities.

RESULTS: Participants’ entry into sex work is characterised by an absence of supportive networks, yet their social isolation is exacerbated by the stigma of sex work. In areas affected by distress migration, adolescent girls and young women entering sex work are younger, and thus particularly vulnerable to abuse and exploitation by brokers, which further undermines their sexual and reproductive health and rights.

CONCLUSION: CSE interventions should include adolescent girls involved in sex work who are under 18, given their heightened vulnerabilities. Interventions should engage with a broader range of stakeholders, including police, social services and legal systems, to enhance the sexual and reproductive health and rights of girls and young women, and address violence and exploitation.

PMID:41635982 | DOI:10.1080/16549716.2025.2606431