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

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Tahilin Sanchez Karver ◽  
Clare Barrington ◽  
Yeycy Donastorg ◽  
Martha Perez ◽  
Hoisex Gomez ◽  
...  

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.

2015 ◽  
Vol 69 (2) ◽  
pp. 216-222 ◽  
Author(s):  
Rose Zulliger ◽  
Clare Barrington ◽  
Yeycy Donastorg ◽  
Martha Perez ◽  
Deanna Kerrigan

2020 ◽  
Vol 32 (3) ◽  
pp. 243-259
Author(s):  
Elke Mitchell ◽  
Elan Lazuardi ◽  
Irma Anintya ◽  
Emily Rowe ◽  
Kate Whitford ◽  
...  

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.


2015 ◽  
Vol 19 (4) ◽  
pp. 715-722 ◽  
Author(s):  
Rose Zulliger ◽  
Cathy Maulsby ◽  
Clare Barrington ◽  
David Holtgrave ◽  
Yeycy Donastorg ◽  
...  

2021 ◽  
Vol 10 (2) ◽  
pp. 169-179
Author(s):  
Lia Andriyani ◽  
Arina Arina ◽  
Asti Widihastuti ◽  
Adi Nugroho

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.


2019 ◽  
Author(s):  
Daniel Nyato ◽  
Soori Nnko ◽  
Albert Komba ◽  
Evodius Kuringe ◽  
Marya Plotkin ◽  
...  

AbstractBackgroundHIV-infected female sex workers (FSWs) have poor linkage to HIV care in sub-Sahara Africa.MethodsWe conducted 21 focus group discussions (FGDs) to explore factors influencing linkage to HIV care among FSWs tested for HIV through a comprehensive community-based HIV prevention project in Tanzania.ResultsInfluences on linkage to care were present at the system, societal and individual levels. System-level factors included unfriendly service delivery environment, including lengthy pre-enrolment sessions, concerns about confidentiality, stigmatising attitudes of health providers. Societal-level factors included myths and misconceptions about ART and stigma. On the individual level, most notable was fear of not being able to continue to have a livelihood if one’s status were to be known. Facilitators were noted, including the availability of transport to services, friendly health care providers and peer-support referral and networks.ConclusionFindings of this study underscore the importance of peer-supported linkages to HIV care and the need for respectful, high-quality care.


2021 ◽  
Vol 21 (2) ◽  
pp. 593-602
Author(s):  
Idah Moyo ◽  
Margaret Macherera

Background: Although sub-Saharan African countries have rolled out massive HIV treatment and care programmes, there is little evidence of these having embraced key population groups particularly female sex workers. Due to the criminalisation of sex work in countries like Zimbabwe, research on HIV and its impact on this group is sparse. The absence of an enabling environment has hindered access to HIV care and treatment services for female sex workers. Objectives: To gain an in-depth understanding of the experiences of female sex workers accessing HIV care and treatment services to enhance programming and planning for this key population group. Methods: This study was qualitative and phenomenological. Data saturation determined the sample size of 20 participants. Data was collected using in-depth interviews that were audio recorded, transcribed, and subjected to thematic content anal- ysis. Results: Our findings demonstrate varying dynamics between the private and public sector HIV care services for sex work- ers, with facilitators and barriers to access to care. Conclusion: Health workers need sensitization and training in the provision of differentiated care. For effective linkage to and retention in care an enabling environment is critical. Keywords: Linkage to care; retention in care; enabling environment; facilitators; barriers.


BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018751 ◽  
Author(s):  
Rebecca Rhead ◽  
Jocelyn Elmes ◽  
Eloghene Otobo ◽  
Kundai Nhongo ◽  
Albert Takaruza ◽  
...  

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.


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