Prostitution Among University Students: A Case Study of Four Public Universities in Ghana

Despite its criminalization in Ghana, prostitution dates back to ancient societies and occurs in various forms within communities. The authors examined prostitution in selected public Universities in Ghana. Methods The study was an exploratory- mixed-method design. Respondents were identied using purposive and snowballing techniques whiles semi-structure questionnaires and in-depth interviews were used for data collection between 2017and 2019. Quantitative data were analyzed using Statistical Package for Social Sciences version 23 and qualitative data analyzed thematically. Findings show that there is a proliferation of prostitution on university campuses in Ghana for nancial, material and emotional gains. Student prostitutes have devised various strategies to combine academic work and prostitution. Prospective customers are solicited by hanging out in drinking bars and night clubs in and around university campuses at night and/or leaving contact details with pimps to be contacted for services. Brothels are also springing up in and around the university campuses in the form of movie houses and student prostitutes convert their hostel rooms into brothels. Price negotiation is based on the environment, duration and styles/positions adopted for sex.


Abstract
Background Despite its criminalization in Ghana, prostitution dates back to ancient societies and occurs in various forms within communities. The authors examined prostitution in selected public Universities in Ghana.

Methods
The study was an exploratory-mixed-method design. Respondents were identi ed using purposive and snowballing techniques whiles semi-structure questionnaires and in-depth interviews were used for data collection between 2017and 2019. Quantitative data were analyzed using Statistical Package for Social Sciences version 23 and qualitative data analyzed thematically.

Results
Findings show that there is a proliferation of prostitution on university campuses in Ghana for nancial, material and emotional gains. Student prostitutes have devised various strategies to combine academic work and prostitution. Prospective customers are solicited by hanging out in drinking bars and night clubs in and around university campuses at night and/or leaving contact details with pimps to be contacted for services. Brothels are also springing up in and around the university campuses in the form of movie houses and student prostitutes convert their hostel rooms into brothels. Price negotiation is based on the environment, duration and styles/positions adopted for sex.

Conclusion
There is a need for a multi-sectoral approach for appropriate policy and program interventions to regulate the practice on campus.

Background
The word prostitution is derived from the Latin word "Prostare" which means publicly selling oneself 1 .
Historically, prostitution dates back to ancient societies and occurs throughout human history 2 . This practice is an age-long phenomenon recorded between 640-556 B.C. 3 and characterized by the provision of sexual favors for nancial 4,5,6 and non-nancial rewards 7 . Despite its immoral undertone, the sale of sexual services is gradually becoming legalized in many countries worldwide 8 and terminologies used to describe prostitution have evolved over the years from paid sex workers, commercial sex workers and slay queens among others to evade the associated stigma 9 .
In Ghana, prostitution is criminalized 10 and de ned as the offering of a person's body for paid sex 11 . Despite its criminalization, prostitution is gaining ground even among children in various forms particularly in big commercial towns 12 . Anecdotal evidence in recent times has also shown the proliferation of commercial sex work (CSW) in and around public Universities in Ghana. There are reported cases of University students indulging in prostitution on university campuses and/or leaving their contacts in various drinking spots, hotels and guest houses to be contacted by customers.
Although various studies exist on prostitution globally and in Ghana 13,14,15 little is known about the practice in public Universities within a restricted country like Ghana. This study, therefore, examined prostitution in and around public universities in Ghana, looking at student involvement, reasons for the practice, customers, modus operandi and cost of services. The ndings of this study will provide empirical evidence to inform policy and program decisions for safer sex practices among students within public universities in Ghana.

Study design
The study design was an exploratory, mystery client and case study using a mixed-method (qualitative and quantitative) approach of data collection. This design was used to give a better understanding of the research problem 16 . The quantitative component allows investigating prostitution objectively without adding self-impressions or understanding 17 whereas, the qualitative component elicited participants' account of their reasons and experiences 18 .

Study setting
The study was conducted in Accra, Kumasi, Cape Coast and Winneba targeting students from the Public Universities located in these setting who are engaged in prostitution in and around these universities. The Universities in these settings were targeted because they are the oldest, more renowned and largest by student population 19 and therefore chosen for the study to ensure that the lifestyle, religion, cultural, and traditional backgrounds of the respondents are relatively homogenous.

Sampling
Twelve key informants (3 taxi drivers, 4 hostel attendants and 5 receptionists at hotels/guest houses operating in and around the universities) were purposively selected and tasked to help locate prostitutes, their joints and time of operations. Research assistants comprising two males, selected from each of the respective university campuses were trained for data collection, using self-administered structured questionnaires and semi-structured in-depth interviews. A total of 100 respondents comprising 25 students from each of the four public universities participated in the study. Twenty in-depth interviews were also conducted to further explore student's experiences of combining prostitution and studies whilst on campus. The participants of the in-depth interviews were mainly randomly sampled nal year student prostitutes (4 females from each of the universities) and all the 4 male student prostitutes identi ed during data collection.

Data collection procedure
The trained eld assistants collected the data between 2017 and 2019 using a questionnaire and an indepth interview guide that were developed and pilot tested by the authors solely for this study. (An English language version has been uploaded as a supplementary les). Respondents were selected purposively using snowball sampling techniques. A list of regular taxi drivers, hotels and guest houses operating in and around the universities was made with the help of research assistants over a period of one month.
Receptionists of the listed hotels and guest houses as well as the identi ed taxi drivers were then contacted one-on-one and informed about the nature, bene ts, risks, purpose of the study, voluntary participation and rights to withdraw. Those who consented to participate in the study were recruited and in-depth interviews [IDIs] were conducted with each of them at places deemed convenient and comfortable for them. The interviews focused on questions on student prostitution in and around the universities, availability of brothels/joint, time of operation and how to contact the student prostitutes.
Information obtained from the key informants were used to identify the student prostitutes recruited for the study. The In-depth Interview sessions lasted for 30 minutes equivalent to a short time engagement of a prostitute and were paid ghs20 for their time as they would have charged a client. In some situations extra money was paid to ensure data saturation since the prostitutes were concerned with time spent on engaging them. Data were collected in English and all interviews were handwritten with consent from respondents in the form of eld notes.

Data Analysis
The quantitative data were analyzed using the Statistical Package for Social Sciences (SPSS) version 23 and presented in a frequency table whiles the qualitative data were analyzed thematically and results presented descriptively. All interviews were documented immediately and were read through to increase familiarity with the data. Data were analyzed using the thematic analysis approach. The documented responses were organized, coded and managed manually. A list of code labels was created and a series of categories for the main themes that emerged were developed.

Ethical considerations
Prior to the commencement of the study, the research protocol was presented at the bi-weekly academic research seminars of the Faculty of Science Education, University of Education, Winneba. The seminar brought together lectures of the Faculty (equivalent to an ethical review meeting) who critiqued and reviewed the study protocol for ethical suitability and sound methodology. The ndings of the study were also subjected to the same scrutiny for endorsement before nalizing the report.
Written and verbal consents were obtained from all participants prior to data collection. Data were collected and managed in a way that did not compromise the privacy and con dentiality of anyone participating in the study. In protecting the privacy and con dentiality of both respondents and eld assistants, details of their a liated institutions, names, addresses and contact numbers were excluded from the report. Additionally, there were no photographs of respondents nor recordings of the interviews which could be used to trace any eld assistants and/or respondents. With these approaches, ndings of the study cannot be attributed to any particular individual, University or particular places where the identi ed prostitutes operate. The eld assistants were all oriented to behave professionally and none judgmental during the eldwork. In this regard, the authors dissociate themselves from any sexual encounters that might have occurred between the eld assistants and the prostitutes before, during and after data collection.

Background Characteristics of respondents
In Table1, the authors presented the background characteristics of the respondents. The majority of the respondent were young people aged 18-24 years (82%), Christians (78%), females(96%), unmarried (80%), foreign students (81%), being catered for by parents (52%), resides in an on-campus rented private hostel (62%) and undergraduates (79%) reading humanities (65%). The emergence of prostitution on public universities campuses Available evidence from the key informants in this study shows that prostitution is being practiced on the campuses of the various public universities in various forms and students adopt various strategies and coping mechanisms for their sex business whilst in school. Students of various backgrounds including men were found prostituting for various reasons.

Mode of operations (modus operandi)
It was reported that some of the student prostitutes visit drinking bars and night clubs in and around the various university campuses at night in search of customers, whilst others operate in their hostel rooms or in a rented room (i.e. hotels, guest houses and brothels) around the various university campuses. There are other categories who are highly paid female and male sex workers who work by appointment with an exclusive clientele. Such students leave their mobile phone contacts and pictures in hotels and guest houses in and around their respective universities to be contacted by prospective customers. Others also work with taxi drivers on the university campuses who link them up to customers, pick and drop them off at various joints and hotels at speci ed times for commissions. Brothels are also springing up in and around the university campuses in the form of movie houses and student prostitutes convert their hostel rooms into brothels. Some key informants reported that: "There are various joints, drinking bars and movie houses around this university that you can nd student prostitutes, particularly at night. I can take you there if you want to see for yourself" (Taxi driver).
Another respondent indicated that: "We have contacts with some students who call us any time when they have a client to pick them for business. Sometimes we pick them to a hotel, guest house or the house of the customer and wait for them till they nish and we bring them back" (Taxi driver).
Another respondents also revealed that: "Prostitution is not allowed at this place but we have some students who come around to leave their contacts and pictures with us just in case a guest wants a woman to hang out with they can be contacted" (Hotel receptionist).

Respondents' view about prostitution
Generally, all respondents were of the view that Prostitutes are unmarried women who have sex with men for material and nancial gains. A respondent was of the view that: "If you are not married and having sex with men for any reason then technically you qualify as a prostitute" (Female, undergraduate student).
Another respondent indicated that: "Any woman who sleeps with more than one man for money is a prostitute" (Female undergraduate student).

Determinants of cost of prostitution services
Prostitution among students was observed as a business and the cost of service was determined by place, duration and type of services (Table 2) as well as the elegancy of the sexual position or styles adopted during the sexual act (Table 3). The reasoning behind the prizing of prostitution services Explaining the reasoning behind prizing of prostitution services some respondents indicated that: We usually charge high prices because we are university students with a high class (Female, undergraduate student) Another respondent indicated that: "Some sexual positions/styles are very aggressive and painful so we charge more to compensate for endurance and buy medications in case of injuries" (Female, undergraduate student).
Another respondent explained: "The missionary position of sexual intercourse is the cheapest because you just have to lie on your back while the man lies face down on top of you and do the work as you relax and even be sleeping if you want to" (Female, postgraduate student). The pricing strategies for male prostitutes vary from those of their female counterparts. A respondent indicated that: "For us men, we don't have customers regularly so our pricing is dependent on the type of customer we get and the situation in which we nd ourselves at the time" (Male, undergraduate student).
Another male respondent explained: "We charge foreigners more than the locals. Sometimes we charge about usd$100 per ejaculation without condoms and usd$50 with condoms" (Male, undergraduate student).
Another respondent was of the view: "My main target is male foreigners although sometimes I also service some sugar mommies on call. Some of the males are homosexual colleague students and university workers who come to my room for sex. In the case of the sugar mommies, they call me on phone and we arrange a place where outside campus we meet, fuck, get my cash and leave" (Male, undergraduate student).
As to whether one is able to offer all the styles enumerated in Table 3 when required, a respondent indicated that: "----why not! Since I'm a master of my business, I always devise strategies to cope. I also learn new styles everyday on the internet, eat well, dress well to keep myself sexy and attractive to men" (Female, diploma student).
Another respondent was of the view that: "Apart from penetrative sex, oral stimulation of the penis, exposure of my vagina to a client and foreplays usually stimulate sexual pleasure and in most cases, some men ejaculate without penetration and have to pay for the service since ejaculation has occurred" (Female, undergraduate student).

Initiation into prostitution
The respondents recalled how they got initiated into the sex business. In most cases it was peer in uence on account of making money and other material gains for personal upkeep whilst in school. Whereas about 35% of the respondents were prostitutes before gaining admission into the universities, the majority (75%) of them including the males were introduced into prostitution during the second year of admission into the university and predominantly by their room, course, social clubs and/or study mates. The sophisticated lifestyles of peers on campus coupled with the nancial or material gains bene ted from the peers were key motivations for easy initiation into prostitution.

Reasons for prostitution
Various reasons other than nancial or material gains were also reported for having multiple sexual encounters. Some respondents explained as follows: "I'm from a very rich home and my friends are surprised to know that I'm in this commercial sex business with them. I don't need money from the men I sleep with but good sex which makes me relax, emotionally stable and put me in a good mood to study for my exams. I not usually satis ed by one man but multiple sexual partners" (Female, undergraduate).
Another respondent indicated that: "I sometimes beg and pay guys to have sex with me in my hostel. In situations when this becomes a challenge, I step onto the street with the intention not to make money but to satisfy myself by having sex with multiple men in brothels. I'm gainfully employed on study leave but not interested in any man for a long/marital relationship" (Female, postgraduate student).

Regular customers of student prostitutes, meeting places and form of remuneration
Data was also collected on the most regular patrons of student prostitutes, meeting places for sexual encounters and forms of remunerations in descending order (Table 4). Challenges encountered by the student prostitutes in the sex business Violence, unwanted pregnancy and Sexually Transmitted Infections were key challenges reported by the student prostitutes. A respondent indicated that: "Sometimes we are beaten up by men in their houses when they pay us and we refuse to do what they expect from us so now we seek protection from pimps" (Female, undergraduate student).
Another respondent indicated that: "There are situations when we become pregnant or get some sexually transmitted diseases. This is why we charge higher if a customer wants raw sex or in the event that a condom gets bursts in action so that we can quickly buy medications to prevent pregnancy and any sexually transmitted diseases" (Female, postgraduate student).
Respondents are very much aware of the various risks associated with prostitution. They have therefore derived various strategies to mitigate the business associated risks (Table 5). Some respondents also indicated that prostitution has some negative consequences on their academic performance in school. A respondent indicated that: "Sometimes 'business' becomes so good that I forget about lectures and follow my customers on appointments. When this happens, I'm not able to partake in class assignments and even miss examinations" (Male, undergraduate student).
Another respondent was of the view that: "Although I pay people to write lecture notes and do assignments for me when I'm absent, it's always di cult to understand the notes so I always don't perform well in my nal exams although I've not been referred in any paper" (Female, diploma student).
Another respondent was of the view that: "My customers sometimes disturbs me so much that I end up losing concentration in school hence not able to attend classes regularly as expected" (Female, undergraduate student).
Some of the female students have devised various strategies including offering sexual favors to some lecturers in exchange for marks to pass examinations. One of such student indicated that: I have a way of seducing my lecturers and teaching assistants to give them good sex in exchange for good marks. The challenge however is, it's not all of them that are morally week to succumb to my seducing no matter how hard I try. I, therefore, pay critical attention to the course being taught by such lectures and teaching assistants in order not to fail (Female, undergraduate student).
On the contrary, some respondents indicated that they are able to combine prostitution and academic work effectively since they claimed to have been among the top-performing students in their class practicing prostitution from the undergraduate level till now at the postgraduate level.

Discussion
In Ghana, Prostitution is stigmatized and illegal but widespread in communities so much so that many Ghanaians are unaware that it is prohibited 20,21 . Despite the social stigma and criminalization of prostitution in Ghana, the practice is becoming common among public university students. Various strategies including hanging out in drinking bars around university campuses at night to be picked, leaving contact numbers and pictures in hotels and guest houses around the universities to be contacted by prospective customers when services are required, while others operate in their hostel rooms or rented private hostels around the campuses. Brothels are also springing up in and around the various university campuses with some branded as movie houses.
The predominate background characteristics of university students observed to have been indulged in prostitution were young people aged 18-24 years (82%), Christians (78%), females(96%), unmarried (80%), foreign students (81%), being catered for by parents (52%), reside on campus in rented private hostels (62%) and undergraduates (79%) reading humanities (65%) is a piece of evidence that the sex business on public university campuses involves young unmarried people of various nationalities who have various social and economic needs believed to be causing a proliferation in the sex business on public university campuses in Ghana.
Although in the minority (4%), some male students were also found indulging in prostitution targeting wealthy men believed to be homosexuals and women (sugar mummies) predominantly for nancial gain.
The huge numbers of foreign students (81%) indulged in prostitution on the various public university campuses con rm media reportage that 'Prostitution is illegal in Ghana but we have not placed strict restrictions on sex tourism in preventing HIV/AIDS, especially when sex is transacted between two consenting adults' 22 . Consequently, Prostitution is being practiced on the campuses of the various public universities in various forms, and students adopt various strategies and coping mechanisms for their sex business whilst in school; not only as means for economic survival but sometimes a basic need for sexual grati cation to cope effectively with academic work on campus. These ndings conform to those of other studies 23,24 which asserted that a large number of university undergraduates indulge in prostitution on various University campuses.
Prostitution among students was observed as a business and the cost of service was determined by place, duration of sex, type of customer, type of services as well as sexual position/style. In most cases, the cost of patronizing the services of a prostitute is negotiable. However, the perceived risk and aggressiveness of the sexual act determine the cost of service and in most cases, the money is collected before the sexual encounter begins. Special negotiable charges apply for anal sex, oral sex and sexual intercourse without condoms as these were perceived as high-risk sexual acts.
Twenty different sexual positions/styles were enumerated and priced accordingly. The Short time and missionary position of sexual intercourse was reported to be the cheapest and most patronized among the package because it's perceived as stress-free. Explaining the reasoning behind prizing of prostitution services, it was noted that some sexual positions/styles are very aggressive and painful hence the cost for such styles is usually high to compensate for endurance and buy medications in case of injuries. The missionary position of sexual intercourse was observed as the cheapest among the 20 enumerated sexual positions available due to its convenience and stress free nature for the female prostitutes. The cost of the other styles are negotiable based on the environment for the sexual encounter, duration and perceived risk by the prostitute.
The observation that customers are made to pay more for unprotected sex and in the event of condoms bursting is an indication that the students' prostitutes are aware of the health risk of unprotected sex but still indulge in it and charging more to be able to pay for the associated health outcomes. This observation, particularly among students of higher institutions of study, defeats public health effort of preventing new infections and spread of STIs including HIV among young people and their patrons. A study on prostitution in Ghana indicates that the effectiveness of AIDS control programs in Ghana depends on enhanced understanding of the social and economic dynamics of prostitution 25 .
The act of initiation into prostitution and reasons for prostitution among university students in Ghana is multifaceted. Peer in uence on account of making money and other material gains for personal upkeep was a key determinant. Negative peer in uence has an impact on prostitution 26 . As peer in uence has effects on the way people think and behave 27,28 . On the contrary, the current study found that prostitution among students in public universities in Ghana is not only for nancial/materials gain but also for emotional stability as revealed that some students became prostitutes because in their view they become more emotionally stable, relaxed and perform academically better if they have sex with multiple partners prior to examinations. Although this could be seen as a form of sex addiction, 29 relating the practice to Maslow's hierarchy of needs, 30 justify their behavior if that could help them achieve other needs. Within the Ghanaian context, a perception with such behavior however could be attributable to demonic possessions which would require deliverance. 31 Students' prostitution comes with the various risks of violence, unwanted pregnancy and STIs. Various strategies such as paid protection and extra charges to mitigate these business associated risks are adopted. With regard to effects on academic performance, the general observation has been that there are various consequences of prostitution on academic performance. The opinion of the University students that the impact of prostitution on their academic performance is that they do not usually pass their examination as expected and therefore do not graduate on time 32,33 . Consequently, some of the female students reported offering sexual favors to some lectures in exchange for marks to pass exams. The presence of male student prostitutes on university campuses and their reasons for indulging in prostitute in school supports ndings of another study on male prostitution which observed that such males resorted to prostitution when they are desperately short of money to the extent of having no access to food or shelter 34 . This practice is very unusual for the expectations of men within the Ghanaian culture and explains the negative in uence of some foreign cultures on students.

Conclusion
The results of this study are revealing as they show that students from the major public universities in Ghana indulge in prostitution in and around the various university campuses for nancial, material and emotional gains. The nding that student prostitutes have devised various strategies including offering sex for marks as a way to combine academic work and the sex business requires further investigations to explore its extent. The springing up of brothels and movie houses in and around the university campuses and the practice of students' converting their hostel rooms into brothels requires law enforcement to prevent or regulate such practices in an academic environment. Price negotiation based on the environment, duration and styles/positions adopted for sex does not only expose the level of prostitution amongst students in public Universities in Ghana but also the conscious and unconscious socioeconomic, cultural, behavioral and moral factors that predispose students to prostitution at the university. The Faulty of Science Education, University of Education, Winneba, approved the study protocol. Verbal consent was also obtained from each respondent for participation.

Consent for publication
All respondents also consented for the anonymous publication of the results.

Availability of data and material
The raw data collected is available upon reasonable request

Competing interests
The authors declared that they have no competing interests.

Funding
This study was fully funded by the authors Authors' contributions JAG conceptualized the study and developed the concept note. FYG designed the study, analyzed the data and developed the draft report. Both authors developed the research instruments and participated in data collection, reviewed the report and nalized it for submission. All authors have read and approved the manuscript, and ensure that this is the case.