A sex worker (SW) is a person who receives money or goods in exchange for sexual services, either regularly or occasionally, and who may or may not consciously define these activities as income-generating [1] . The term violence Gender-based violence (GBV) encompasses violence that occurs as a result of normative gender role expectations as well as unequal power relations between the sexes in the context of a specific society [2] . GBV treatment of women has become an international public health and human rights issue in recent decades [3] . Although they are the ones who suffer disproportionately from GBV, they are not the only ones; men can also be the target [4] . Research on the risks faced by FSWs is classified into two main risk categories: the risks of experiencing violence and the risks of contracting and transmitting STIs. FSWs are part of vulnerable populations and are dramatically affected by violence, especially sexual violence, with often serious consequences [5] [6] [7] . The literature shows that people performing sex work are more at risk than the general population of experiencing different types of violence and contracting sexually transmitted infections (STIs) [8] . The violence suffered by sex workers is of little interest for research, but nevertheless constitutes a major health and safety problem [9] . Some studies have been carried out in the world, [9] [10] [11] [12] which respectively noted a prevalence of 82%, 44%, 57% and 90%. In Africa, some data on violence against FSWs are available. In 2016 in Cameroon, Decker reported that 60% of the FSWs among whom she had carried out her study had been victims of sexual violence [13] . In Ethiopia in 2015, in Tanzania in 2018, and in Uganda in 2021, the prevalence of GBV among FSWs was respectively 75.6%, 30.0% and 61.0% [14] [15] [16] . In CAR, for every hour that passes, three people experience GBV [17] [18] [19] . No study has yet focused on the study GBV among FSWs, even though they would be as exposed if not more than the general population. This is why we propose to assess the extent of the GBV phenomenon among FSWs in the city of Bangui, the capital city of the CAR.

This is a descriptive cross-sectional epidemiological study covering the period from July to October 2021, i.e., a duration of 4 months. This study took place in Bangui, capital of the CAR. The study population consisted of FSWs in Bangui, united in an association. The data collection method adopted was interviews. The FSWs were met according to a defined schedule for face-to-face interviews during which a pre-established questionnaire was completed by the investigator himself, after reading the explanatory note and answering any questions and obtaining the written signed consent of the participant. The theoretical size of the sample, determined according to Schwartz’s formula [19] , was 369. Given that the association only had 159 FSWs in Bangui, an exhaustive sampling was adopted. All FSWs present during the data collection period and having given their written signed consent were included in the study. The parameters studied were sociodemographic characteristics: age, sex, residence, level of education, marital status, and characteristics linked to violence: the notion of violence during their professional activity, the type of violence, the declaration and if necessary, the response and management of this violence.

The data collected was coded, entered, processed and analyzed using Epi info version 7 software. The averages of quantitative variables and the proportions of qualitative variables were determined. The survey was carried out with strict respect for the dignity, integrity and right to privacy of the participants.

In total, of the 159 female SWs (FSWs) in the association, 108 had been found at the headquarters of their association, had given their consent and had therefore been included, i.e. a participation rate of 67.9%. The average age of the participants was 27.0 years with extremes of 14 and 46 years. The age groups of 25 to 34 were the most represented (43.5%). Fifty-six FSWs (51.9%) had reached secondary level. Very few participants reached university (2.8%). Unemployed FSWs were in the majority at 74.1%; none was a state civil servant ( Table 1 ).

Sixty-six (66) FSWs in our sample (61.1%) had already been victims of violence during the exercise of their activity. Sixty-eight (62.9%) wanted to stop the professional activity of FSWs and 93.1% would accept another income-generating activity to replace sex work ( Table 2 ).

Among the types of violence suffered, sexual violence ranked first with 28.5%, including 6.2% sexual exploitation. Verbal violence came in second place with 22.4% while physical violence (20.5%) and economic violence (20.45%) had almost equal proportions ( Figure 1 ).

The study of gender-based violence (GBV) among FSWs took place in Bangui, CAR over a period of 4 months. Its objective was to assess the extent of the GBV phenomenon among FSWs. The sampling was exhaustive and 108 out of 159 FSWs that were present during the study period and gave their consent. This gives a participation rate of 67.9%. The average age of FSWs was 27.0 years with

extremes of 14 to 46 years. The age groups of 25 to 34 years were the most represented 43.5%. The unemployed constituted 74.1% of our sample. Sixty-six (66) of the FSWs surveyed (61.1%) had already been victims of violence and 62.9% wanted to stop this professional activity, while 93.1% would accept another income-generating activity. The most frequently reported violence was sexual (28.5%), verbal (22.4%), physical (20.5%), economic (20.4%) and psychological (8.2%). These results show that young adult age (average 27.0 years, 15 - 34 years: 81.5%), level of secondary education (51%), unemployed (74.1%) characterize the profile of women workers in sex.

The main limitation of the study lies in the small sample size. According to Schwartz’s formula [9] , the sample size should be 369. The association which hosted the study only had 159 members. To recruit the maximum possible number of FSWs, the study systematically included all those who were present at the association’s headquarters during the study period. However, only 108 were included. Thus, with this sample, above results were obtained, which are discussed below. Sex work, not often accepted by morals and the law, often exposes FSWs to violence of all kinds. Farley noted in 1998 in San Francisco that 82% of FSWs surveyed had been physically assaulted and 68% raped while working as prostitutes [8] . In Vancouver in 2005, 90% of SWs surveyed had already been victims of violence [10] . Church reported that half of her samples were victims of violence perpetrated by their clients [7] . In Kenya 87% of prostitutes interviewed by Roberts had been victims of GBV [20] . In the CAR, a country in the midst of military-political conflicts, violence is present and accompanies these conflicts [18] . In addition, gender-based violence (GBV) is common among FSWs [6] . All of this combined leads us to believe that this proportion of 61.1% of GBV among FSWs in our study does not reflect reality. The under-reporting of GBV by the FSWs in our study is probably due to fear of stigmatization and misunderstanding [20] , as is the case in Central African society, few women complain of sexual violence. This same observation was made Adama City, Ethiopia in 2013 by Mooney [5] . Among the 61.1% of FSWs in our study who had already suffered violence, 28.5% declared sexual violence, 22.4% verbal violence, 20.5 % physical violence, 20.4% economic violence and 8.2% psychological violence. Even if sexual violence seemed to have a low proportion in our series (28.5%), it remains the first category of violence as noted by Farley in 2005 in Vancouver [10] . His study noted that 90% of FSWs surveyed had already suffered violence of various types, including 78% of sexual violence [10] . Prejudices and stigma, associated with the legislative context, strongly influence the living and working conditions of FSWs [5] . This category of worker is often confronted with different forms of violence, often avoids complaining and often does this work out of necessity for survival [21] . These difficult working conditions often make FSWs want to quit if they had another source of income [10] . This is what our study reveals because among the PS surveyed, 62.9% declared their desire to stop this professional activity and 93.1% would accept another income-generating activity. The fact that 74.1% of our samples were unemployed persons suggested that most of them do the sex work as income-generating activity and confirm this data about their desire to change their activity. Because of the risk of GBV and STIs, opportunity could be given those who like to change activity to do so. The importance of this subject merits further analysis to measure access to social services and the stigmatization of sex workers, who are not recognized in the world of work in the Central African Republic.

GBV against FSWs in the CAR is on a considerable scale. They are of different types but are killed by the victims. Fear of discrimination, stigmatization and misunderstanding prevents them from declaring it. The lack of financial means to ensure survival forces them to continue doing this work, but the majority are ready to stop sex work if they have another source of income. It is necessary to supervise them, and to support them towards professional retraining for those who want it, otherwise to protect them within the framework of respect for human rights, rather than criminalizing and exploiting them, flouting their human dignity and putting their lives in danger.