HIV Risk Perception Among Migrant Girl Head Porters (Kayayei) in Ghana

This study investigates perceptions and fears of acquired immunodeficiency syndrome (AIDS) among female migrant head porters (locally known as Kayayei) in Accra's Makola and Agbogbloshie markets. The term 'head porter' refers to young migrant women who transport goods on their heads for a fee in large urban markets, a labour practice common in West African trading environments. Using the health belief model (HBM), the study explores cognitive and emotional responses to human immunodeficiency virus (HIV)/AIDS. A mixed-methods approach was utilized, including a cross-sectional survey of 400 respondents, two focus group discussions with 24 participants, and 20 key informant interviews with market leaders and child protection officers. Quantitative results indicated that 83.5% of respondents viewed AIDS as a dangerous disease, whereas 85.5% expressed fear of contracting the infection. Age and education showed no significant association with fear, although junior high school education correlated with greater awareness of disease severity. Qualitative findings identified five major reasons underlying fear, including perceptions of incurability and visible suffering associated with AIDS, whereas those who expressed little fear cited divine protection, confidence in modern treatment or fatalistic beliefs about illness. The HBM illuminated variations in perceived susceptibility, severity and self-efficacy. Despite relatively high awareness of HIV/AIDS, structural and economic barriers continue to limit the adoption of protective behaviours. The study advocates for culturally responsive HIV interventions that strengthen self-efficacy, address misconceptions and better reflect the lived realities of migrant adolescent girls and young women.