scholarly journals “But I Gathered My Courage”: HIV Self-Testing as a Pathway of Empowerment Among Ugandan Female Sex Workers

2021 ◽  
Vol 31 (3) ◽  
pp. 443-457
Author(s):  
Jonas Wachinger ◽  
Daniel Kibuuka Musoke ◽  
Catherine E. Oldenburg ◽  
Till Bärnighausen ◽  
Katrina F. Ortblad ◽  
...  
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
Sense Of Self ◽  
Qualitative Interviews ◽  
Hiv Treatment ◽  
Prevention Services ◽  
Female Sex ◽  
Treatment And Prevention ◽  
Self Testing ◽  
Framework Approach

HIV self-testing (HIVST) increases HIV testing in diverse populations, but little is known about the experiences of individuals who self-test. We used a five-step framework approach to analyze 62 qualitative interviews with 33 female sex workers (FSWs) participating in an HIVST trial in urban Uganda. Notions of empowerment emerged from the data, and findings were interpreted based on Kabeer’s empowerment framework of resources, agency, and achievements. We found that access to HIVST bolstered empowerment because it increased participant’s time and money (resources), control of testing circumstances and status disclosure (agency), and sense of competency (achievements). In addition, we found that knowledge of HIV status empowered participants to better control HIV-related behaviors (agency) and recognize a new sense of self (achievements). This suggests that the availability of HIVST can facilitate feelings of empowerment, meriting a higher awareness for benefits outside of linkage to HIV treatment and prevention services.

Declines in HIV prevalence in female sex workers accessing an HIV treatment and prevention programme in Nairobi, Kenya over a 10-year period

AIDS ◽  
2021 ◽  
Vol 35 (2) ◽  
pp. 317-324
Author(s):  
Achieng Tago ◽  
Lyle R. McKinnon ◽  
Tabitha Wanjiru ◽  
Festus Muriuki ◽  
Julius Munyao ◽  
...  
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
Hiv Prevalence ◽  
Hiv Treatment ◽  
Prevention Programme ◽  
Female Sex ◽  
Treatment And Prevention

scholarly journals Challenges and Support to HIV Care and Treatment of Female Sex Workers Living with HIV in Indonesia: A Mixed Method Study

2021 ◽  
Vol 10 (2) ◽  
pp. 169-179
Author(s):  
Lia Andriyani ◽  
Arina Arina ◽  
Asti Widihastuti ◽  
Adi Nugroho
Keyword(s):  
Mixed Method ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Qualitative Interviews ◽  
Hiv Treatment ◽  
Load Test ◽  
Hiv Care ◽  
Female Sex ◽  
Care And Treatment ◽  
Living With Hiv

This study aims to describe the experience of female sex workers (FSWs) living with HIV in Indonesia during the care and treatment cascade, including the challenges and support associated with them. It was initiated by a trained community study team from OPSI, a national network for FSW community in the country. A mixed-method design was used, consisting of a cross-sectional survey and qualitative interviews conducted in four large cities in May and June 2019. Quantitative data were collected from 80 FSWs living with HIV, while qualitative interviews were conducted for 9 FSWs previously involved in the survey. Most of the FSWs were diagnosed with HIV at facility-based HIV testing services. While most FSWs delayed initiating their treatment, majority eventually commenced it. Overall treatment retention was fairly good, but some were being inconsistent or even stopped. However, individuals that have access to viral load test was low, leading to a small number of those confirming their viral suppression status. Conclusively, interventions directed to strengthen individuals’ literacy in HIV treatment and stigma management is recommended, as well as identification of maximum potential support systems around the FSWs.

scholarly journals HIV testing and its associated factors among street-based female sex workers in Iran: results of a national rapid assessment and response survey

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sina Ahmadi ◽  
Mehrdad Khezri ◽  
Payam Roshanfekr ◽  
Salah Eddin Karimi ◽  
Meroe Vameghi ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Associated Factors ◽  
Female Sex Workers ◽  
Rapid Assessment ◽  
Evidence Based ◽  
Multivariable Model ◽  
Sexually Transmitted ◽  
Female Sex ◽  
Self Testing

Abstract Background Female sex workers (FSWs) are at a disproportionate risk of sexually transmitted infections and they may face significant barriers to HIV testing. This study aimed to examine HIV testing prevalence and its associated factors among street-based FSWs in Iran. Method A total of 898 FSWs were recruited from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Eligible FSWs were women aged 18 years of age who had at least one commercial sexual intercourse in the previous year. HIV testing was defined as having tested for HIV in the lifetime. Bivariable and multivariable logistic regression were used to examine the correlates of HIV testing. We report adjusted odds ratios (aOR) and their 95% confidence intervals (CI). Result Overall, 57.8% (95%CI: 20.0, 88.0) of participants reported having tested for HIV, and HIV prevalence among FSWs who tested for HIV was 10.3% (95%CI: 7.5, 13.0). The multivariable model showed that unstable housing (aOR: 8.86, 95%CI: 2.68, 29.32) and drug use (aOR: 3.47, 95%CI: 1.33, 9.06) were associated with increased likelihood of HIV testing. However, FSWs with a higher level of income were less likely to be tested for HIV (aOR: 0.09, 95%CI: 0.02, 0.43). Conclusion Almost one in ten street-based FSWs had never tested for HIV. These findings suggest the need for evidence-based strategies such as outreach support and HIV self-testing to improve HIV testing in this marginalized population.

scholarly journals Do female sex workers have lower uptake of HIV treatment services than non-sex workers? A cross-sectional study from east Zimbabwe

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018751 ◽  
Author(s):  
Rebecca Rhead ◽  
Jocelyn Elmes ◽  
Eloghene Otobo ◽  
Kundai Nhongo ◽  
Albert Takaruza ◽  
...  
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
Household Survey ◽  
Hiv Treatment ◽  
Sample Survey ◽  
Physical And Mental Health ◽  
Hiv Knowledge ◽  
Cross Sectional ◽  
Female Sex ◽  
Treatment Services

ObjectiveGlobally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake.MethodsData from a household survey conducted in 2009–2011 and a parallel snowball sample survey of FSWs were matched using probability methods to reduce under-reporting of FSWs. HIV treatment cascades were constructed and compared for FSWs (n=174) and NSWs (n=2555). Determinants of service uptake were identified a priori in a theoretical framework and tested using logistic regression.ResultsHIV prevalence was higher in FSWs than in NSWs (52.6% vs 19.8%; age-adjusted OR (AOR) 4.0; 95% CI 2.9 to 5.5). In HIV-positive women, FSWs were more likely to have been diagnosed (58.2% vs 42.6%; AOR 1.62; 1.02–2.59) and HIV-diagnosed FSWs were more likely to initiate ART (84.9% vs 64.0%; AOR 2.33; 1.03–5.28). No difference was found for antiretroviral treatment (ART) adherence (91.1% vs 90.5%; P=0.9). FSWs’ greater uptake of HIV treatment services became non-significant after adjusting for intermediate factors including HIV knowledge and risk perception, travel time to services, physical and mental health, and recent pregnancy.ConclusionFSWs are more likely to take up testing and treatment services and were closer to achieving optimal outcomes along the cascade compared with NSWs. However, ART coverage was low in all women at the time of the survey. FSWs’ need for, knowledge of and proximity to HIV testing and treatment facilities appear to increase uptake.

HIV self-testing in Pune, India: perspectives and recommendations of female sex workers and peer educators

AIDS Care ◽  
2019 ◽  
Vol 32 (2) ◽  
pp. 182-185 ◽  
Author(s):  
Yanni M. Chang ◽  
Tejaswi Sevekari ◽  
Ann Duerr ◽  
Yamilé Molina ◽  
Trupti Gilada
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
Peer Educators ◽  
Female Sex ◽  
Self Testing

scholarly journals The Effect of HIV Self-Testing Delivery Models on Female Sex Workers’ Sexual Behaviors: A Randomized Controlled Trial in Urban Uganda

2019 ◽  
Vol 23 (5) ◽  
pp. 1225-1239 ◽  
Author(s):  
Katrina F. Ortblad ◽  
Daniel Kibuuka Musoke ◽  
Thomson Ngabirano ◽  
Aidah Nakitende ◽  
Guy Harling ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Sexual Behaviors ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Female Sex ◽  
Self Testing ◽  
Delivery Models

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

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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