The HIV Care Cascade Among Female Sex Workers in Zimbabwe

Given the disproportionate HIV burden faced by female sex workers FSWs and limited data regarding their engagement in the HIV cascade of care in conflict-affected settings, we characterized the cascade of care and examined associations with new HIV diagnoses and antiretroviral therapy (ART) use in a community-based cohort of FSWs in conflict-affected Northern Uganda. Data were collected via FSW/peer-led time-location sampling and outreach, interview-administered questionnaires, and voluntary HIV testing. Of 400 FSWs, 33.5% were living with HIV, of whom 33.6% were new/previously undiagnosed infections and 32.8% were on ART. Unstable housing and heavy alcohol/drug use were independently associated with increased odds of new HIV diagnoses, whereas exposure to condom demonstrations and number of lifetime pregnancies were negatively associated. In subanalysis among known HIV-positive women, age and time since diagnosis were associated with ART use, whereas sexually transmitted infections were negatively associated. Findings suggest the need for FSW-tailored, peer-based, and integrated HIV and sexual and reproductive health programs to address gaps in HIV testing and treatment for FSWs in conflict-affected communities.

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High Drop-off Along the HIV Care Continuum and ART Interruption Among Female Sex Workers in the Dominican Republic

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000000590 ◽

2015 ◽

Vol 69 (2) ◽

pp. 216-222 ◽

Cited By ~ 32

Author(s):

Rose Zulliger ◽

Clare Barrington ◽

Yeycy Donastorg ◽

Martha Perez ◽

Deanna Kerrigan

Keyword(s):

Dominican Republic ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum ◽

Female Sex

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Facilitators and barriers to incorporating digital technologies into HIV care among cisgender female sex workers living with HIV in South Africa

mHealth ◽

10.21037/mhealth.2019.12.07 ◽

2020 ◽

Vol 6 ◽

pp. 15-15 ◽

Cited By ~ 1

Author(s):

William X. You ◽

Carly A. Comins ◽

Brooke A. Jarrett ◽

Katherine Young ◽

Vijayanand Guddera ◽

...

Keyword(s):

South Africa ◽

Sex Workers ◽

Female Sex Workers ◽

Digital Technologies ◽

Hiv Care ◽

Female Sex ◽

Facilitators And Barriers ◽

Living With Hiv

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A Qualitative Exploration of Family, Work, Community, and Health Service Influences on HIV Treatment Uptake and Adherence Among Female Sex Workers in Three Cities in Indonesia

AIDS Education and Prevention ◽

10.1521/aeap.2020.32.3.243 ◽

2020 ◽

Vol 32 (3) ◽

pp. 243-259

Author(s):

Elke Mitchell ◽

Elan Lazuardi ◽

Irma Anintya ◽

Emily Rowe ◽

Kate Whitford ◽

...

Keyword(s):

Support Groups ◽

Sex Workers ◽

Female Sex Workers ◽

Treatment Initiation ◽

Geographical Location ◽

Hiv Treatment ◽

Hiv Care ◽

Community Based ◽

Female Sex ◽

Outreach Workers

Qualitative data were collected from 34 Indonesian female sex workers to understand their engagement with HIV treatment. Influences that enhanced treatment initiation and adherence included women's desires to stay healthy to continue working to provide for families; awareness of the biomedical benefits of treatment; support from bosses, outreach workers, and peer support groups; and flexible, nonjudgmental HIV service provision. Influences inhibiting treatment initiation and adherence included concerns about unwanted disclosure in the workplace and side effects of medication on women's capacity to earn money through sex work; geographical location of services; discrimination and confidentiality concerns in HIV care services. To improve HIV treatment initiation and adherence among Indonesian female sex workers, future responses should explore health promotion messages that engage with women's family and livelihood obligations; increased funding for community-based peer outreach workers; community-based treatment initiation and supply; and advocacy in work environments to secure support for treatment initiatives.

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Retention in HIV Care Among Female Sex Workers in the Dominican Republic: Implications for Research, Policy and Programming

AIDS and Behavior ◽

10.1007/s10461-014-0979-5 ◽

2015 ◽

Vol 19 (4) ◽

pp. 715-722 ◽

Cited By ~ 15

Author(s):

Rose Zulliger ◽

Cathy Maulsby ◽

Clare Barrington ◽

David Holtgrave ◽

Yeycy Donastorg ◽

...

Keyword(s):

Dominican Republic ◽

Sex Workers ◽

Female Sex Workers ◽

Research Policy ◽

Hiv Care ◽

Female Sex ◽

Retention In Hiv Care

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The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi

PLoS ONE ◽

10.1371/journal.pone.0147662 ◽

2016 ◽

Vol 11 (1) ◽

pp. e0147662 ◽

Cited By ~ 27

Author(s):

Kathryn Elizabeth Lancaster ◽

Kimberly A. Powers ◽

Thandie Lungu ◽

Pearson Mmodzi ◽

Mina C. Hosseinipour ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Hiv Care ◽

Hiv Care Continuum ◽

Care Continuum ◽

Female Sex ◽

Key Population

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

10.21203/rs.2.12428/v3 ◽

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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Exploring peer navigation and support in the quality of HIV care experiences of female sex workers in the Dominican Republic

BMC Health Services Research ◽

10.1186/s12913-021-07439-4 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Tahilin Sanchez Karver ◽

Clare Barrington ◽

Yeycy Donastorg ◽

Martha Perez ◽

Hoisex Gomez ◽

...

Keyword(s):

Dominican Republic ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Treatment ◽

Hiv Care ◽

Care Providers ◽

Female Sex ◽

Care Services ◽

Peer Navigation

Abstract Background Despite evidence on peer navigation’s association with positive HIV outcomes, such as engagement in HIV care and antiretroviral therapy (ART) initiation, the mechanisms through which peer navigation may influence these outcomes have been less explored. The purpose of this study is to describe the role of peer navigation and support on enhancing the quality of HIV treatment and care services experienced by female sex workers (FSWs). Methods Survey data was derived from a quantitative cohort (n = 211) of FSWs living with HIV in the Dominican Republic and complemented with data from two rounds of in-depth interviews (IDIs) from a qualitative subsample (n = 20 per round). Descriptive statistics and multivariable logistic regressions were used to explore the association between peer navigation and relational aspects of care and overall satisfaction of the quality of HIV treatment and care. Thematic analysis was employed to code and synthesize textual data from IDIs. Results 41.2% of the participants reported having had contact with a peer navigator in the last 6 months. Qualitative data revealed that peer navigation and support was instrumental in assisting FSWs linkage to HIV care after diagnosis, elevating FSWs’ ability to access more comprehensive clinical care facilities, and promoting agency by improving FSWs’ skills to more strategically and effectively engage with the clinic environment and health care providers. Peer navigation was positively associated with experiencing more respectful treatment by clinic staff (AOR: 6.65, 95% CI: 2.32–19.02), and greater satisfaction with overall HIV care services (AOR: 2.57, 95% CI: 1.77–3.74). Conclusion Promoting the full integration of peer navigation into healthcare structures is a strategic approach to enhance the quality of HIV care experienced by FSWs and improve their HIV-related outcomes.

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