Are services meeting the holistic family planning needs of female sex workers living with HIV in Tanzania?

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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HIV pre‐exposure prophylaxis for female sex workers: ensuring women’s family planning needs are not left behind

Journal of the International AIDS Society ◽

10.1002/jia2.25442 ◽

2020 ◽

Vol 23 (2) ◽

Cited By ~ 1

Author(s):

Anna L Bowring ◽

Frances H Ampt ◽

Sheree Schwartz ◽

Mark A Stoové ◽

Stanley Luchters ◽

...

Keyword(s):

Family Planning ◽

Sex Workers ◽

Female Sex Workers ◽

Left Behind ◽

Female Sex ◽

Exposure Prophylaxis

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“A dream come true”: Perspectives on long-acting injectable antiretroviral therapy among female sex workers living with HIV from the Dominican Republic and Tanzania

PLoS ONE ◽

10.1371/journal.pone.0234666 ◽

2020 ◽

Vol 15 (6) ◽

pp. e0234666 ◽

Cited By ~ 4

Author(s):

Deanna Kerrigan ◽

Tahilin Sanchez Karver ◽

Ohvia Muraleetharan ◽

Virginia Savage ◽

Jessie Mbwambo ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Dominican Republic ◽

Sex Workers ◽

Female Sex Workers ◽

Female Sex ◽

Long Acting ◽

Living With Hiv

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

mHealth ◽

10.21037/mhealth.2019.12.07 ◽

2020 ◽

Vol 6 ◽

pp. 15-15 ◽

Cited By ~ 1

Author(s):

William X. You ◽

Carly A. Comins ◽

Brooke A. Jarrett ◽

Katherine Young ◽

Vijayanand Guddera ◽

...

Keyword(s):

South Africa ◽

Sex Workers ◽

Female Sex Workers ◽

Digital Technologies ◽

Hiv Care ◽

Female Sex ◽

Facilitators And Barriers ◽

Living With Hiv

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HIV testing behaviour and HIV prevalence among female sex workers in Ukraine: findings from an Integrated Bio-Behavioural Survey, 2013–2014

Sexually Transmitted Infections ◽

10.1136/sextrans-2018-053684 ◽

2019 ◽

Vol 95 (3) ◽

pp. 193-200 ◽

Cited By ~ 1

Author(s):

Anna Tokar ◽

Iana Sazonova ◽

Sharmistha Mishra ◽

Pavlo Smyrnov ◽

Tetiana Saliuk ◽

...

Keyword(s):

Hiv Testing ◽

Sex Work ◽

Sex Workers ◽

Sexual Partner ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Factors Associated ◽

Female Sex ◽

Living With Hiv ◽

Test Result

ObjectivesUkraine has one of the largest HIV epidemics in Europe, with high prevalence among female sex workers (FSWs). We aimed to identify factors associated with HIV testing and receipt of the test result in the last 12 months, HIV prevalence and self-reported positive status among FSWs in Ukraine.MethodsWe used data from an Integrated Bio-Behavioural Survey among FSWs conducted in 2013–2014. The survey methodology combined three sampling strategies: time and location sampling, respondent-driven sampling and key informant recruitment. We used multivariable regression to identify factors associated with self-reported HIV testing in the last 12 months, HIV prevalence and self-reported positive status among FSWs living with HIV. Explored factors included: age, age at first sex, age at entry into sex work, education, marital status, employment status beside sex work, condom use with last paying or non-paying sexual partner, drug or alcohol consumption and sex work venue.ResultsRecent HIV testing was low overall with only 63.2% of FSWs reported having tested and received their test result in the last 12 months prior to the survey. HIV prevalence was 7.1% overall, but only 45.0% of FSWs living with HIV were aware of their HIV status. Testing in the last 12 months with receipt of test result was less common among FSWs who used drugs ever in life (adjusted OR (AOR) 0.7, 95% CI 0.6 to 0.9), women soliciting clients indoors (AOR 0.8, 95% CI 0.7 to 0.9) and those not using a condom with last paying sexual partner (AOR 0.3, 95% CI 0.2 to 0.5). HIV positivity was associated with history of ever using drugs (AOR 2.3, 95% CI 1.4 to 3.6) and soliciting clients outdoors (AOR 1.5, 95% CI 1.1 to 2.0). Women working indoors were less aware of their positive status (AOR 0.1, 95% CI 0.1 to 0.9).ConclusionHIV prevalence is high among FSWs in Ukraine, and testing and knowledge of one’s status remain insufficient. HIV testing programmes need to expand with strategies to reach specific subgroups of FSWs.

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