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

ObjectivesWhile female sex workers (FSW) are nearly 14 times more likely to be living with HIV than non-FSW, less than 40% of FSW living with HIV are on antiretroviral therapy (ART). We sought to understand how the work environment influences ART access and adherence for FSW in preparation for the Siyaphambili trial.MethodsFSW living with HIV (n=24) and key informants (n=15) were recruited to participate in semistructured in-depth interviews using maximum variation and snowball sampling, respectively. FSW were recruited on key variants including type of sex work venue, primary work time and history of ART use. Data were collected between September and November 2017 in Durban, South Africa. Interviews were audio-recorded, transcribed and translated. Data were then coded applying grounded theory in Atlas.ti.ResultsFSW experienced occupational barriers to adherence including work-related migration, substance use and theft of ART on the job. Fear of wage loss due to HIV disclosure to clients and brothel managers prevented some FSW from accessing ART at their clinic and taking medications while working. FSW employed coping strategies to overcome barriers including sharing ART with colleagues, carrying small supplies of ART and visiting the clinic prior to appointments for ART refills. Further, some FSW received adherence support from colleagues who were also living with HIV.ConclusionsConsidering these occupational pressures on FSW and supporting positive coping strategies are important when designing and implementing HIV treatment programmes. Findings suggest strengthening social cohesion and supporting differentiated care efforts to improve HIV outcomes among FSW living with HIV.

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Engagement in the HIV care cascade and barriers to antiretroviral therapy uptake among female sex workers in Port Elizabeth, South Africa: findings from a respondent-driven sampling study

Sexually Transmitted Infections ◽

10.1136/sextrans-2016-052773 ◽

2016 ◽

Vol 93 (4) ◽

pp. 290-296 ◽

Cited By ~ 30

Author(s):

Sheree Schwartz ◽

Andrew Lambert ◽

Nancy Phaswana-Mafuya ◽

Zamakayise Kose ◽

Mfezi Mcingana ◽

...

Keyword(s):

South Africa ◽

Antiretroviral Therapy ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Care ◽

Respondent Driven Sampling ◽

Hiv Care Cascade ◽

Female Sex ◽

Care Cascade ◽

Port Elizabeth

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

Unnes Journal of Public Health ◽

10.15294/ujph.v10i2.40037 ◽

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.

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