Substance use practices in sex-work and sexual minorities in Uganda; developing consequential counselling tools


Recreation is part of growing up and an improvement to quality of life. However, some substances like alcohol, psycho-active drugs taken in form of smoke or beverages have inherent destructive effects to life.
In Uganda, sex-work, same sex and substance users’ networks have common issues ranging from fact that they are marginalised and continuously vilified. Due to this condition, they seek to drown down the depression by use of substances (alcohol, smoking, injectable drugs, and psycho-active beverages).
These networks are so vast and deep sitted most of them starting off at one’s early age.
Substance use may hinder informed decisions towards safer sex practices and this opens way for infections. Substance use in the homes and communities leads to many forms of violence and abuses. These have caused the increase in numbers of crimes committed every day and nuisances. It has also led to traumatic incidents like expulsion from homes due to use.

1.      Misuse of alcohol, tobacco, inhalants, and other drugs is now widespread in Uganda and in these communities and causes substantial health problems.
2.      Nicotine in tobacco is a powerfully addictive substance with multiple physiologic and psychological effects.
3.      Tobacco withdrawal symptoms make it difficult for individuals to quit, are variable among individuals, and usually include unpleasant effects such as anxiety, irritability, difficulty concentrating, restlessness, impatience, hunger, tremor, racing heart, sweating, dizziness, nicotine craving, insomnia, drowsiness, headaches and digestive disturbances.
4.      A common bad reaction to marijuana is the "acute panic anxiety reaction."
5.      Long-term regular users of marijuana may become psychologically dependent. They may have a hard time limiting their use, they may need more of the drug to get the same effect, and they may develop problems with their jobs and personal relationships.
6.      Drug abuse is a risk factor to non-communicable diseases like heart failure, mental illnesses and hypertension.


Substance use in sex-work and same sex sexual behaviour can be detrimental to productive survival skills. It may partly explain why there is low self esteem and poor health practices in these communities. Lack of employable skills is one of the reasons that many people seek substance use as an alternative to drown depressions.


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