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.

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 ◽  
...  
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.

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 Facilitators and Barriers to Linkage to HIV Care and Treatment among Female Sex Workers in a Community-based HIV Prevention Intervention in Tanzania: a qualitative study

2019 ◽  
Author(s):  
Daniel Nyato ◽  
Soori Nnko ◽  
Albert Komba ◽  
Evodius Kuringe ◽  
Marya Plotkin ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Sex Workers ◽  
Female Sex Workers ◽  
System Level ◽  
Hiv Care ◽  
Care Providers ◽  
Community Based ◽  
Infected Female ◽  
Female Sex ◽  
Linkage To Hiv Care

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.

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

2015 ◽  
Vol 69 (2) ◽  
pp. 216-222 ◽  
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

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.

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