Depressive Symptoms, Alcohol, and Drug Dependence among Female Sex Workers in Kisumu, Kenya: A Cross-Sectional Study

Abstract

Female sex workers (FSW) have increased likelihood of depressive symptoms, alcohol and drug dependence. Analysis of cross-sectional baseline data from 407 women in a trial of menstrual cups was done to assess depressive symptoms (PHQ-9), alcohol (AUDIT) and drug dependence (DAST). Multinomial logistic regression identified factors associated with having 2 or 3 elevated scores, relative to having no elevated score. Median age was 27.3 years; 60% of the FSWs had less than secondary education, 41% had other jobs besides sex work, and over half (52.9%) reported experiencing sexual abuse during childhood. The prevalence of depressive symptoms was 20% (15% mild, 5% moderate or higher). One quarter (25%) of participants had some classification for alcohol dependence, and 15% were classified as having potentially hazardous drug dependence. Multiple problems were identified in 14.4% of participants. The results highlight the interconnectedness of mental health, drugs and alcohol use among FSWs in western Kenya. (Afr J Reprod Health 2026; 30 [14]:75-85).