Structural Barriers to Receiving Health Care Services for Female Sex Workers in Russia

Abstract Background Hong Kong has gained a good reputation for its quality public health care services. However, there is a growing recognition that social stigma is a potential obstacle when female sex workers (FSWs) access health care services. There are a lack of studies focusing on how FSWs experience and cope with stigma when accessing health care services in Hong Kong. Objective This study aims to explore how FSWs experience stigma and develop coping strategies when accessing health care services in Hong Kong. Methods This is a qualitative interview study. Staff of non-governmental organizations (NGOs) that serve sex workers in Hong Kong facilitated the process of recruiting the participants. In-depth individual interviews were conducted with 22 FSWs, focusing on their experiences of stigma and coping strategies when accessing health care services. A directed content analysis approach was adopted to analyze the data. Results The interview data can be grouped into three themes: experience of stigma in the health care setting; coping with the stigma of sex work; and the call for non-judgmental holistic health care. Conclusion This study contributes to an understanding of the experience of stigma and stigma coping strategies of FSWs when accessing health care services in Hong Kong. stigma remains an important issue for a large proportion of FSWs when they seek timely professional help, openly disclose their sex work identity, and receive comprehensive health care services. The study also highlights the need to address multiple healthcare needs of FSWs beyond STDs. Moreover, the study contributes to increasing awareness of, and respect for, the human right of FSWs to receive non-discriminatory health services.

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Why and According to What Consultation Profiles Do Female Sex Workers Consult Health Care Professionals? A Study Conducted in Laval, Québec

Health Care For Women International ◽

10.1080/07399330701738226 ◽

2008 ◽

Vol 29 (2) ◽

pp. 165-182 ◽

Cited By ~ 11

Author(s):

Minh-Nguyet Nguyen ◽

Thérèse Venne ◽

Isabel Rodrigues ◽

Julie Jacques

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Sex Workers ◽

Female Sex Workers ◽

Female Sex

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Stigma as a barrier to health care utilization among female sex workers and men who have sex with men in Burkina Faso

Annals of Epidemiology ◽

10.1016/j.annepidem.2017.11.009 ◽

2018 ◽

Vol 28 (1) ◽

pp. 13-19 ◽

Cited By ~ 13

Author(s):

Hae-Young Kim ◽

Ashley Grosso ◽

Odette Ky-Zerbo ◽

Marcel Lougue ◽

Shauna Stahlman ◽

...

Keyword(s):

Health Care ◽

Health Care Utilization ◽

Burkina Faso ◽

Sex Workers ◽

Female Sex Workers ◽

Care Utilization ◽

Female Sex ◽

Sex With Men

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Medical Students’ Knowledge and Attitudes Toward Female Sex Workers and Their Occupational Risk Factors

International Journal of Medical Students ◽

10.5195/ijms.2014.97 ◽

2014 ◽

Vol 2 (3) ◽

pp. 104-108 ◽

Cited By ~ 1

Author(s):

Jenna T. Nakagawa ◽

Muge Akpinar-Elci.

Keyword(s):

Health Care ◽

Medical Education ◽

Medical Students ◽

Sex Workers ◽

Female Sex Workers ◽

Medical Training ◽

Physician Attitudes ◽

Care Providers ◽

Occupational Risk Factors ◽

Female Sex

Background: The tendency for female sex workers to seek health care is highly influenced by physician attitudes and behavior. By identifying medical students' attitudes toward female sex workers and assessing their knowledge of barriers to seeking care, we can focus medical training and advocacy efforts to increase access to care and improve public health outcomes. Methods: In this cross-sectional study, medical students from various countries were invited to participate in an online survey with close-ended questions and Likert scale statements. Responses were quantified and knowledge and attitude scores were assigned based on knowledge of barriers to seeking care and agreement with positive and negative attitude statements. Results: A total of 292 medical students from 56 countries completed the survey, of whom 98.3% agreed that it will be their job to provide treatment to patients regardless of occupation. Self-identified religious students conveyed more negative attitudes toward female sex workers compared to those who did not identify themselves as religious (p<0.001). Students intending to practice in countries where prostitution is legal conveyed more positive attitudes compared to those intending to practice in countries where prostitution is illegal (p<0.001). Conclusion: Medical students largely agreed on the importance of providing care to female sex workers as a vulnerable group. In addition to addressing knowledge gaps in medical education, more localized studies are needed to understand the religious and legal influences on attitudes toward female sex workers. Such information can help focus the efforts in both medical education and communication training to achieve the desired behavioral impacts, reconciling the future generations of health care providers with the needs of female sex workers.

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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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Feasibility and acceptability of a peer-led HIV self-testing model among female sex workers in Malawi: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2021-049248 ◽

2021 ◽

Vol 11 (12) ◽

pp. e049248

Author(s):

Moses K Kumwenda ◽

Webster Mavhu ◽

Wezzie S Lora ◽

Richard Chilongosi ◽

Simon Sikwese ◽

...

Keyword(s):

Qualitative Study ◽

Hiv Testing ◽

Sex Workers ◽

Female Sex Workers ◽

Peer Pressure ◽

Distribution Model ◽

Hiv Status ◽

Female Sex ◽

Care Services ◽

Self Testing

ObjectivesHIV testing is the gateway to HIV prevention and care services. Female sex workers (FSW) may benefit from HIV self-testing (HIVST), which offers greater control and confidentiality than other approaches. However, FSW also have unique vulnerabilities, making it critical to understand their perspective of HIVST to best contextualise HIVST to their needs. This study explored feasibility and acceptability of providing oral fluid-based peer-led HIVST to FSW to inform tailored HIVST delivery approaches.DesignQualitative study.SettingMalawi.ParticipantsThirty-nine FSW who had obtained a HIVST kit and eight peer distributors.ResultsPeer distributors’ accounts suggested that peer-led HIVST is feasible. Overall, FSW spoke positively about peer-led HIVST and younger FSW preferred it to facility-based HIV testing. FSW highlighted both greater control of their testing experience and that HIVST could allow them to avoid discriminatory attitudes frequently experienced in public facilities. Some also felt that HIVST kits could enable them to establish the HIV status of their sexual partners, better informing their decisions about condomless sex. Despite overall acceptance of HIVST, a few expressed doubts in the procedure. Some FSW already aware of their HIV-positive status reported using HIVST. A few accounts suggested peer pressure to self-test predominantly from peer distributors.ConclusionsThis study enabled us to explore feasibility and acceptability of peer-led HIVST among FSW, as well as potential shortcomings of the HIV testing modality. Peer distributors are a welcome additional model. However, they should avoid distribution in actual venues. Programmes should ensure a range of testing options are available and expand peer’s representation. Study findings will be used to tailor the HIVST distribution model to ensure its enhanced uptake among key populations in general and FSW, specifically.

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