To
The Editors: Plos One [plosone@plos.org]
Mr Joshua Kimani [jkimani@csrtkenya.org]

11 October 2013

Dear Mr Kimani and co-authors, and the Editors and Reviewers of article “Enumeration of Sex Workers in the Central Business District of Nairobi, Kenya”

Inclusion of map of hot spots in sex work enumeration study report: why it is unethical and should be withdrawn immediately

We are a collective of international researchers, sex workers, NGO's and public health practitioners from the Global South and the Global North.

We have read with interest the article “Enumeration of Sex Workers
in the Central Business District of Nairobi, Kenya” . We commend the authors on conducting much-needed research on sex workers in Africa, and the rigour of the research and methodology. We are however greatly troubled by the publication in the public domain of a map indicating sex worker ‘hot spots’ in Kenya, the location of which could be used by police and others to the violent detriment of the research participants involved.

Our experience working with sex workers across Africa and abroad, and in
navigating the spaces where sex workers and police frequently meet, shows
the intense vulnerability of this population to police brutality. This has been documented in Africa, and specifically in Kenya. Sex work is illegal in Kenya – a fact the authors themselves point out – which increases sex worker vulnerability to police violence and abuse of power.

Against this background, it is highly unethical to publish a map in which a marginalised population could be identified and geographically pinpointed. It is obvious from the map provided where the enumeration was conducted and alarmingly, where sex workers can be located. While the authors have removed the street names, the map is an exact likeness of Nairobi CBD and identifies specific locations where sex workers can be found, and in what numbers (see for example the juxtaposition of the included map and a Google Map search on “SWOP-City”).
The map is available as a public document which can be accessed by anyone with an internet connection. The commendable open access nature of Plos One publications, expands the reach of academic publications and knowledge, but paradoxically increases the danger of abuse of sensitive information. The map adds little value to the article and it is not clear to us why the authors felt that they needed to include such detailed information, and why the editors and reviewers overlooked the dangers of such an addition. While the map would be useful for the provision of health care services and rights-based responses to sex work, such information should be provided to such agencies on an individual basis and on a confidential/restricted basis.

An ethical and moral obligation is placed on all researchers to not harm research participants in any way. Ethical research necessitates respect for research participants and doing no harm, and importantly an assessment of risks and benefits. While the enumeration study itself received ethics clearance, the publication of a detailed map containing a summary of data of a vulnerable population would never.

We would like to request that the authors and editors withdraw the map from the public domain with immediate effect. In addition, we would like to urge the authors to investigate whether any harm has been caused to the study participants in the area covered, and to implement measures to reduce potential harm in future.

We would like to request the editor of PloS One to forward this letter of concern to the reviewers of the article and highlight their failure to notice the potential harm in the publication of such sensitive information. We recommend that PLos One drafts an editorial policy on the additional scrutiny and caution required of publication of maps of highly stigmatised and marginalised populations, and include members of such groups in the review of articles in future.

We look forward to your response.


Yours Sincerely




Yolanda Anderson-De Monk, South Africa
Pamela Chakuvinga, Sisonke Sex Worker Movement, South Africa
Jenny Coetzee, Researcher, Perinatal HIV Research Unit, South Africa
Dr Wim Delva, International Centre for Reproductive Health, Ghent University, Ghent, Belgium; and South African DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis Stellenbosch University, Stellenbosch, South Africa
Dr Melissa Ditmore, USA
Anna Forbes, Independent consultant, USA
Renata Mares, PhD Candidate, Australia
Dr Alice M. Miller, Global Health Justice Partnership of the Yale Law School and the School of Public Health
Lara Quarterman, researcher.
Dr Marlise Richter, International Centre for Reproductive Health, Ghent University and African Centre for Migration & Society, Wits University, South Africa [marlise.richter@gmail.com]
Dr Rebecca Schleifer, USA
Sally Shackleton, Sex Worker Education & Advocacy Taskforce, South Africa
Prof Svati P. Shah, Gender and Sexuality Studies, University of Massachusetts, Amherst
Dr Carole S. Vance, Mailman School of Public Health, Columbia University
Dr Jo Vearey, African Centre for Migration & Society, University of the Witwatersrand