‘People need to know we exist!’: an exploratory study of the labour experiences of transmasculine and non-binary sex workers and implications for harm reduction

2022 ◽  
pp. 1-15
Author(s):  
Angela Jones
Keyword(s):  
Harm Reduction ◽  
Sex Workers ◽  
Exploratory Study

scholarly journals High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lisa J. Messersmith ◽  
Rose Adjei ◽  
Jennifer Beard ◽  
Angela R. Bazzi ◽  
Joel J. Earlywine ◽  
...  
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Population Size ◽  
Sex Workers ◽  
People Who Inject Drugs ◽  
Syringe Sharing ◽  
Unsafe Sex ◽  
Lack Of Information ◽  
Sex With Men ◽  
Major Drug

Abstract Background Drug use is a growing concern in Ghana. People who inject drugs (PWID) are highly vulnerable to HIV and other infectious diseases. Ghana’s National Strategic Plan for HIV/AIDS 2016–2020 identifies PWID as a key population, but efforts to address the needs of PWID have lagged behind those targeting sex workers and men who have sex with men. Lack of information about PWID is a critical barrier to implementing effective HIV prevention and treatment. We aimed to learn more about the vulnerability of the PWID population in order to inform much-needed harm reduction interventions. Methods From April to July 2018, we conducted a mixed methods study in Kumasi, Ghana, to identify all major drug using locations, count the numbers of PWID to obtain rough population size estimations, and administer anonymous surveys to 221 PWID regarding drug use and sexual behavior. We also tested for HIV, HCV, and HBV from syringes used by survey participants. Results Key informants identified five major drug using locations and estimated the total PWID population size to be between 600 and 2000. Enumerators counted between 35 and 61 individuals present at each of the five bases. Sharing syringes and reusing discarded syringes are common practices. Over half of survey participants (59%) reported past-month syringe sharing (34% used a used syringe and 52% gave away a used syringe). Individuals with higher injection frequency (≥ 21 times weekly) and who injected with four or more people had higher odds of syringe sharing. Of the survey participants reporting sex in the last month (23%), most reported having one partner, but only 12% used condoms. Nearly all women (11/13) reported exchanging sex for drugs and 6/13 reported exchanging sex for money in the last six months. Fifteen percent of participants (all men) reported paying for sex using drugs or money. Of the used syringes, prevalence estimates were 3% (HIV), 2% (HCV), and 9% (HBV). Conclusions Our findings confirm the urgent need to implement harm reduction interventions targeting PWID and to build a strong and enabling legal and policy environment in Ghana to support these efforts.

Harm reduction for sex workers

The Lancet ◽  
2006 ◽  
Vol 367 (9513) ◽  
pp. 814 ◽  
Author(s):  
Smarajit Jana ◽  
Wiwat Rojanapithayakorn ◽  
Richard Steen
Keyword(s):  
Harm Reduction ◽  
Sex Workers

Structure and agency: reflections from an exploratory study of Vancouver indoor sex workers

2011 ◽  
Vol 13 (1) ◽  
pp. 15-29 ◽  
Author(s):  
Vicky Bungay ◽  
Michael Halpin ◽  
Chris Atchison ◽  
Caitlin Johnston
Keyword(s):  
Sex Workers ◽  
Exploratory Study ◽  
Structure And Agency

scholarly journals Female sex workers perspectives and concerns regarding HIV self-testing: An exploratory study in Tanzania

2019 ◽  
Author(s):  
Soori Nnko ◽  
Daniel Nyato ◽  
Evodius Kuringe ◽  
Caterina Casalini ◽  
Amani Shao ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Exploratory Study ◽  
Female Sex Workers ◽  
Health Care Facilities ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Female Sex ◽  
Self Testing ◽  
Study Participants

Abstract Background: HIV testing is a gateway to HIV care and treatment for those testing positive and can link those with negative results to HIV preventive services. Despite the importance of HIV testing services (HTS) in HIV control, uptake of HTS among female sex workers (FSWs) across sub-Saharan Africa (SSA) remains sub optimal. Concerns about stigma associated with sex work and fear of loss of livelihood if HIV status becomes known, are some of the restrictions for FSWs to utilize HTS offered through health care facilities. Introduction of HIV self-testing (HIVST) may mitigate some of the barriers for the uptake of HTS. This study explored perspectives of FSWs towards HIVST in Tanzania. Methods: We conducted an exploratory study employing in-depth interviews (IDI) and participatory group discussions (PGD) with FSWs in selected regions of Tanzania. Study participants were recruited through snowball sampling. Data were thematically analysed by two analysts using NVivo software. Emerging themes were explored in the tradition of Grounded Theory. The analysis was informed by the social ecological model and focused on factors associated with the feasibility of scaling up HIVST. Results: A total of 23 PGD sessions were conducted involving 227 FSWs. Data from PGDs were complemented by 21 IDI. FSWs were enthusiastic toward HIVST. Convenience (time and cost saved), and belief that HIVST will increase privacy and confidentiality motivated participants’ support for the self-testing approach. Participants did express concerns about their ability to interpret and trust the results of the test. Participants also expressed concern that HIVST could cause personal harm, including severe distress and self-harm for individuals with reactive test. This was linked to the study participants’ perception that HIVST would be provided only through unassisted modality. Conclusions: FSWs demonstrated high enthusiasm to use the HIVST once it becomes available. Increased confidentiality, reduced opportunity costs, and increased autonomy were among the key factors for the intended use of HIVST. Major concerns included fear of HIV reactive test and not trusting self-diagnoses. Our findings underscore the importance of providing adequate access to counselling and referral services in conjunction with HIVST.

scholarly journals An evaluation of a community-based combination HIV prevention intervention for female sex workers (FSW) in Baltimore, Maryland: EMERALD study design (Preprint)

2020 ◽  
Author(s):  
Bradley Silberzahn ◽  
Catherine A. Tomko ◽  
Emily Clouse ◽  
Katherine Haney ◽  
Sean T. Allen ◽  
...  
Keyword(s):  
United States ◽  
At Risk ◽  
Harm Reduction ◽  
Randomized Trial ◽  
Sex Workers ◽  
Female Sex Workers ◽  
The United States ◽  
Community Empowerment ◽  
Outreach Program ◽  
Female Sex

BACKGROUND Cisgender female sex workers (FSW) experience high rates of HIV and sexually transmitted infections (STIs) including chlamydia and gonorrhea. Community empowerment-based responses to the risk environment of female sex workers have been associated with significant reductions in HIV/STI risk and associated risk behaviors, yet evaluations of U.S. based interventions targeting FSW are limited. OBJECTIVE We describe the design, implementation, and evaluation of an ongoing comprehensive community-level intervention targeting FSW in Baltimore City, Maryland. METHODS The two intervention components are the SPARC drop-in center and the accompanying comprehensive mobile outreach program (in the west Baltimore area). The mission of SPARC is to provide low-barrier harm reduction services to at-risk non-men, with a special focus on women who sell sex and use drugs. SPARC addresses clients’ needs through nonjudgmental, convenient, safe, and non-stigmatizing interactions. Services are provided through a harm reduction framework and include: reproductive health and sexual health screenings; medication assisted treatment; legal aid, counseling; showers, lockers, laundry; and the distribution of harm reduction tools including naloxone and sterile drug use supplies (e.g., cookers, cotton, syringes, pipes). The SPARC intervention is being evaluated through the EMERALD study, which consists of: a prospective two-group comparative non-randomized trial (n=385); a cross sectional survey (n=100); and in-depth interviews assessing SPARC implementation (n=45). Participants enrolled in the non-randomized trial complete a survey and HIV/STI testing at four intervals (baseline, 6-, 12-, 18-months). Participants recruited from pre-defined areas closest to SPARC comprised the intervention group, and participants from all other areas of Baltimore were in the control. RESULTS We hypothesize that addressing structural drivers and more immediate medical needs, in combination with peer outreach, will lead to community empowerment and reduce FSWs’ HIV/STI cumulative incidence and behavioral risks. CONCLUSIONS In the United States, structural interventions aimed to reduce HIV and STIs among FSW are scarce, and to our knowledge this is the first intervention of its kind in the United States. The results of the EMERALD study can be used to inform the development of future interventions targeting FSW and other at-risk populations. CLINICALTRIAL NCT04413591

scholarly journals Female sex workers perspectives and concerns regarding HIV self-testing: An exploratory study in Tanzania

2019 ◽  
Author(s):  
Soori Nnko ◽  
Daniel Nyato ◽  
Evodius Kuringe ◽  
Caterina Casalini ◽  
Amani Shao ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Exploratory Study ◽  
Female Sex Workers ◽  
Health Care Facilities ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Female Sex ◽  
Self Testing ◽  
Study Participants

Abstract Background: HIV testing is a gateway to HIV care and treatment for those testing positive and can link those with negative results to HIV preventive services. Despite the importance of HIV testing services (HTS) in HIV control, uptake of HTS among female sex workers (FSWs) across sub-Saharan Africa (SSA) remains sub optimal. Concerns about stigma associated with sex work and fear of loss of livelihood if HIV status becomes known, are some of the restrictions for FSWs to utilize HTS offered through health care facilities. Introduction of HIV self-testing (HIVST) may mitigate some of the barriers for the uptake of HTS. This study explored perspectives of FSWs towards HIVST in Tanzania. Methods:We conducted an exploratory study employing in-depth interviews (IDI) and participatory group discussions (PGD) with FSWs in selected regions of Tanzania. Study participants were recruited through snowball sampling. Data were thematically analysed by two analysts using NVivo software. Emerging themes were explored in the tradition of Grounded Theory. The analysis was informed by the social ecological model and focused on factors associated with the feasibility of scaling up HIVST. Results:A total of 23 PGD sessions were conducted involving 227 FSWs. Data from PGDs were complemented by 21 IDI. FSWs were enthusiastic toward HIVST. Convenience (time and cost saved), and belief that HIVST will increase privacy and confidentiality motivated participants’ support for the self-testing approach. Participants did express concerns about their ability to interpret and trust the results of the test. Participants also expressed concern that HIVST could cause personal harm, including severe distress and self-harm for individuals with reactive test. This was linked to the study participants’ perception that HIVST would be provided only through unassisted modality. Conclusions: FSWs demonstrated high enthusiasm to use the HIVST once it becomes available. Increased confidentiality, reduced opportunity costs, and increased autonomy were among the key factors for the intended use of HIVST. Major concerns included fear of HIV reactive test and not trusting self-diagnoses. Our findings underscore the importance of providing adequate access to counselling and referral services in conjunction with HIVST.

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