Imagine that staple of primary education, a Venn diagram. In one circle is the issue of post-conflict violence – what happens after a long war ends. In the other circle are young sex workers and their risk for HIV. Now imagine the area where those circles overlap. That’s where Katherine Muldoon’s research sits.
Muldoon, a doctoral student in the School of Population and Public Health at the University of British Columbia and the recipient of a CAHR doctoral award, is carrying out research in a relatively new field, social epidemiology. She is part of a larger research team investigating how the chaos of a post-conflict environment not only give rise to an epidemic of violence, but can affect the likelihood that young sex workers will be infected with HIV. While the presence of sex work in conflict and post-conflict settings has not gone unnoticed by local populations and organizations, it has so far remained a gap in the research.
The study takes place in northern Uganda, where a 24-year civil war has recently ended. It includes 400 young women who have engaged in sex for survival in the past 30 days. The average age of these women is 21 years (range 19-25). Many have at least one biological child and are caring for other family members as well.
“One of the findings is that women find themselves under extreme pressure to provide for themselves and their families,” says Muldoon.
Because so many of them have lived in displaced persons camps, away from their homes and without the protections of their traditional lifestyles, there is more opportunity for sexual mixing with older men. As a result of the pressure to support their families, many find income by exchanging sex for resources, either for commercial purposes or to gain the protection of a “sugar-daddy” figure. And intergenerational sex, Muldoon says, is a behaviour that continues to be one of the highest risks for HIV infection.
Muldoon’s research, though being carried out in an African post-war environment, far from the comparative safety of Vancouver, is being informed by an earlier study carried out in Vancouver by Dr. Kate Shannon, Director of the Gender and Sexual Health Initiate at the BC Centre for Excellence in HIV/AIDs (and Muldoon’s doctoral co-supervisor, together with Dr. Jean Shoveller of UBC), where Muldoon has worked for the past five years. She hopes that this study will help close a gap in the research.
“I’m hoping we’ll bring together evidence to inform policies, programs and planning to bring attention to this marginalized group,” she says. “A gendered analysis of the consequences of war on the lives of women is needed – and of men, too.”
“Katie’s PhD research has the potential to make significant contributions to improved health equity for some of the most marginalized women in sex work, globally,” says Dr. Shannon. “Post-conflict environments create a huge space of social, economic and gender inequities. This transitional environment, together with growing Ugandan government efforts to further criminalize HIV-positive individuals, sexual minorities and sex workers, raises alarms for adequate HIV prevention, treatment and care for young women in East Africa.”
Receiving a doctoral research award from CAHR, she says, completely changed her life, allowing her to focus on something she is passionate about.
“I am so grateful for that award,” Muldoon says. “This is what I do all of time now. I am very passionate about this research.”
For the future, Muldoon says that global health and social epidemiology will continue to be her area of interest. Her goal is to contribute to the body of evidence on social structures contributing to the burden of violence among marginalized populations. She plans to apply for post-doctoral funding to continue her research and aspires for a career as an academic researcher.
