scholarly journals HIV Vulnerability Among Survival Sex Workers Through Sexual Violence and Drug Taking in a Qualitative Study From Victoria, Canada, With Additional Implications for Pre-exposure Prophylaxis for Sex Workers

2022 ◽  
Vol 6 ◽  
Author(s):  
Bryan Eric Benner
Keyword(s):  
Qualitative Study ◽  
Hiv Infection ◽  
Sexual Violence ◽  
Sex Workers ◽  
Health And Safety ◽  
Community Setting ◽  
Theory Approach ◽  
Convenience Sample ◽  
Survival Sex ◽  
Exposure Prophylaxis

Objective: This qualitative study investigates how social and structural forces mediate vulnerability to HIV infection and transmission among survival sex workers, their clients, and their non-commercial, intimate partners—with especial focus on sexual violence and drug taking.Method: I employed an adapted grounded theory approach to conducting and analyzing (n = 9) open-ended, in-depth interviews with a convenience sample of currently working (and recently exited) survival sex workers from a community setting in Victoria, Canada.Findings: Participants revealed important contexts and conditions under which they were vulnerable to HIV infection. At the behavioural level, participants were aware of how HIV could be transmitted (condomless sex and sharing drug equipment), yet participants voiced strongly how structural and systemic features (for instance, client violence, the need for drugs, and “bad date” referrals) could squeeze and constrain their agency to take up safer practices, mediating their optimal HIV health and safety. Some participants reported strained relationships with police because of previous drug involvement.Conclusion: Survival sex workers constitute a health population vulnerable to HIV infection, and ensuring there could be a supportive (outreach) community replete with HIV resources is paramount. The availability of safer sex and drug equipment play important roles in HIV behavioural prevention efforts. However, uptake of pre-exposure prophylaxis (PrEP) at no cost in the Canadian province of British Columbia could be an important and beneficial structural intervention for non-injection drug taking cis-female sex workers in this study who are presently ineligible for no cost PrEP.

scholarly journals A Qualitative Study of Provider Thoughts on Implementing Pre-Exposure Prophylaxis (PrEP) in Clinical Settings to Prevent HIV Infection

PLoS ONE ◽  
2012 ◽  
Vol 7 (7) ◽  
pp. e40603 ◽  
Author(s):  
Emily A. Arnold ◽  
Patrick Hazelton ◽  
Tim Lane ◽  
Katerina A. Christopoulos ◽  
Gabriel R. Galindo ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hiv Infection ◽  
Clinical Settings ◽  
Exposure Prophylaxis

scholarly journals Typology of older female sex workers and sexual risk for HIV infection in China: a qualitative study

2013 ◽  
Vol 16 (1) ◽  
pp. 47-60 ◽  
Author(s):  
Chun Hao ◽  
Hongjie Liu ◽  
Susan G. Sherman ◽  
Baofa Jiang ◽  
Xiaojing Li ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hiv Infection ◽  
Sexual Risk ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Female Sex

scholarly journals HIV control strategies for sex worker–client contact networks

2019 ◽  
Vol 16 (158) ◽  
pp. 20190497
Author(s):  
Nicola Mulberry ◽  
Alexander R. Rutherford ◽  
Ralf W. Wittenberg ◽  
Brian G. Williams
Keyword(s):  
Sex Workers ◽  
Control Strategies ◽  
Treatment Strategies ◽  
Hiv Prevalence ◽  
Bipartite Network ◽  
Structural Factors ◽  
Relative Population ◽  
Survival Sex ◽  
Sexual Contacts ◽  
Exposure Prophylaxis

Controlling the spread of HIV among hidden, high-risk populations such as survival sex workers and their clients is becoming increasingly important in the ongoing fight against HIV/AIDS. Several sociological and structural factors render general control strategies ineffective in these settings; instead, focused prevention, testing and treatment strategies which take into account the nature of survival sex work are required. Using a dynamic bipartite network model of sexual contacts, we investigate the optimal distribution of treatment and preventative resources among sex workers and their clients; specifically, we consider control strategies that randomly allocate antiretroviral therapy and pre-exposure prophylaxis within each subpopulation separately. Motivated by historical data from a South African mining community, three main asymmetries between sex workers and clients are considered in our model: relative population sizes, migration rates and partner distributions. We find that preventative interventions targeted at female sex workers are the lowest cost strategies for reducing HIV prevalence, since the sex workers form a smaller population and have, on average, more sexual contacts. However, the high migration rate among survival sex workers limits the extent to which prevalence can be reduced using this strategy. To achieve a further reduction in HIV prevalence, testing and treatment in the client population cannot be ignored.

scholarly journals HIV self‐testing and oral pre‐exposure prophylaxis are empowering for sex workers and their intimate partners: a qualitative study in Uganda

2021 ◽  
Vol 24 (9) ◽  
Author(s):  
Andrew Mujugira ◽  
Agnes Nakyanzi ◽  
Vicent Kasiita ◽  
Brenda Kamusiime ◽  
Grace K. Nalukwago ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Sex Workers ◽  
Intimate Partners ◽  
Self Testing ◽  
Exposure Prophylaxis

scholarly journals Drug users’ perceptions, demands, and suggestions for non-occupational post-exposure prophylaxis (nPEP) services in China: a qualitative study

2019 ◽  
Author(s):  
Kedi Jiao ◽  
Haochu Li ◽  
Dapeng Zhang ◽  
Zhenxia Jiang ◽  
Yuxi Lin ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hiv Infection ◽  
Drug Users ◽  
Basic Knowledge ◽  
High Price ◽  
Small Scale ◽  
Post Exposure Prophylaxis ◽  
High Risk Population ◽  
Post Exposure ◽  
Exposure Prophylaxis

Abstract Background Drug users are regarded as a high-risk population of HIV infection. Non-occupational post-exposure prophylaxis (nPEP) is internationally regarded as an effective biomedical prevention against HIV but still a small-scale pilot project in China at present. The aim of this study was to understand drug users’ perceptions demands and suggestions for nPEP service in China.Methods Nineteen eligible drug users were recruited in this qualitative study. Semi-structured in-depth interviews were conducted by trained interviewers. All of the interviews were audio-taped, transcribed verbatim and analyzed using thematic framework analysis.Results Most of participants had not heard of nPEP and none of them had used this service. After being informed basic knowledge of nPEP, about half of the participants reported willingness to use it. The facilitators included scare of HIV infection and regarding nPEP as a remedial measure in emergency. The barriers included low willingness for fatigue and lethargy after taking drugs, high price and side effects of nPEP medication, long course of nPEP treatment, and fear of privacy disclosure. Most of the participants thought the availability of nPEP would not increase the occurrence of unprotected intercourse and supported the routinization of nPEP services. Most participants chose social media for nPEP propaganda and pharmacies for providing nPEP.Conclusions It is imperative to strengthen propaganda and education of nPEP among drug users, and to encourage them to proactively use nPEP after exposure. Price regulation, side effect management and privacy protection need to be managed well when nPEP is routinized.

scholarly journals Oral PrEP: Is it only a pill to be swallowed: a qualitative study among female sex workers in India

2020 ◽  
Author(s):  
Seema Sahay ◽  
Archana Verma ◽  
Suhas Shewale ◽  
Sampada Dhayarkar ◽  
Athokpam Bijeshkumar ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Qualitative Study ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Theory Approach ◽  
Care Providers ◽  
Targeted Interventions ◽  
Female Sex ◽  
Willingness To Use ◽  
Oral Prep

Abstract Background Empowering female sex workers (FSWs) through women controlled HIV prevention option has been in focus globally. The success of targeted interventions among FSWs indicates that this population could become an important and feasible target for oral PrEP (Pre Exposure Prophylaxis). A qualitative study was conducted to study FSWs’ willingness to use oral PrEP in India.Methods In-depth interviews (n=39) and two focus group discussions (n=14) were conducted at 3 high HIV prevalence urban and rural sites in India among FSWs. Key informant interviews (n=34) were conducted with a bisexual man, 6 brothel keepers and 27 Health Care Providers (HCPs). The study explored issues around willingness to use oral PrEP. The study was approved by the respective institutional ethics committee of the study sites. Thematic analysis using the grounded theory approach was used to analyze the data in N-VIVO version 8.0. Results FSWs were willing to use daily oral PrEP and hoped to use it as an alternative to the male condom. One of the emerging themes showed that the situations of condom-less sex over which FSWs had no control. This made them desire oral PrEP which was easy to use and geared to provide independence, financial gains, and privacy. HCP initiated oral PrEP was not acceptable. However, HCPs pointed out safety monitoring needs. For FSWs, safety concerns pertained to their own physical/ aesthetic attributes and reproductive system in a major way. Adherence emerged as a challenge because of: 1) FSWs’ prevalent habit and need of alcohol use; 2) their notion of daily dosing being too mundane; 3) Stigma because Oral PrEP is ARV based. Alcohol use and dread of repetitive dose bring forth the need for long-acting oral PrEP. Conclusion Oral PrEP is acceptable among FSWs; it should be rolled out alongside strong messages on STI protection given the perceptions of FSWs that oral PrEP might replace condoms. Education about ARV-based oral PrEP needs to be spelled to prevent stigma. Adherence counseling should take cognizance of FSWs’ lifestyle, specifically making oral PrEP less of a mundane task.

scholarly journals Drug users’ perceptions, demands, and suggestions for non-occupational post-exposure prophylaxis (nPEP) services in China: a qualitative study

2020 ◽  
Author(s):  
Kedi Jiao ◽  
Haochu Li ◽  
Dapeng Zhang ◽  
Zhenxia Jiang ◽  
Yuxi Lin ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hiv Infection ◽  
Drug Users ◽  
Basic Knowledge ◽  
High Price ◽  
Small Scale ◽  
Post Exposure Prophylaxis ◽  
High Risk Population ◽  
Post Exposure ◽  
Exposure Prophylaxis

Abstract Background Drug users are regarded as a high-risk population of HIV infection. Non-occupational post-exposure prophylaxis (nPEP) is internationally regarded as an effective biomedical prevention against HIV but still a small-scale pilot project in China at present. The aim of this study was to understand drug users’ perceptions, demands and suggestions for nPEP service in China. Methods Nineteen eligible drug users were recruited in this qualitative study. Semi-structured in-depth interviews were conducted by trained interviewers. All of the interviews were audio-taped, transcribed verbatim and analyzed using thematic framework analysis. Results Most of participants had not heard of nPEP and none of them had used this service. After being informed basic knowledge of nPEP, about half of the participants reported willingness to use it. The facilitators included scare of HIV infection and regarding nPEP as a remedial measure in emergency. The barriers included low willingness for fatigue and lethargy after taking drugs, high price and side effects of nPEP medication, long course of nPEP treatment, and fear of privacy disclosure. Most of the participants thought the availability of nPEP would not increase the occurrence of unprotected intercourse and supported the routinization of nPEP services. Most participants chose social media for nPEP propaganda and pharmacies for providing nPEP. Conclusions It is imperative to strengthen propaganda and education of nPEP among drug users, and to encourage them to proactively use nPEP after exposure. Price regulation, side effect management and privacy protection need to be managed well when nPEP is routinized.

Through the looking-glass: Objectivity, interpretation, and the construction of social kinds as emerging issues in research ethicss

2007 ◽  
Vol 30 (4) ◽  
pp. 75
Author(s):  
S G Berkhout ◽  
M W Tyndall ◽  
S Anderson
Keyword(s):  
Public Health ◽  
Hiv Infection ◽  
Social Relations ◽  
Sex Workers ◽  
Ethical Problem ◽  
Charles Taylor ◽  
Human Action ◽  
Social Identities ◽  
Survival Sex ◽  
Vulnerable Communities

Background: Access to the means of knowledge production is severely limited for many individuals who are socially, politically, and economically disadvantaged. Of particular concern, largely overlooked in bioethics discourse, is the manner by which surveillance, identification, and classification contribute to the creation of particular populations based on harmful social identities, and the subsequent stigmatization of the individuals subject to analysis. Methods: Drawing from a range of philosophical and sociological literature, including Hans-Georg Gadamer, Charles Taylor, Bruno Latour, and Deborah Lupton, as well as public health discourse, this paper gives an analysis of a challenging metaphysical and ethical problem related to research practices and public health interventions in vulnerable communities. The themes of objectivism and stigmatization are illuminated by focusing on research related to HIV infection among survival sex workers in Vancouver’s downtown eastside. Results: Reductionist models of human behaviour presuppose a clear distinction between description and evaluation, contributing to an understanding of social reality as structured by objective, base level data, and misconstruing modes of social relations as individual action. In the context of HIV risk, an ethical problem emerges: describing individual actions as “data,” or “fact,” serves to construct and reinforce transgressive social identities. Given that stigmatization is itself part of the context of adverse health outcomes and HIV infection, practices relying on methods that presume representational authority and fail to critically interpret human action are ethically problematic. Resolving difficulties within the methodological underpinnings of public health and HIV behavioural research requires an understanding of many social science methods as hermeneutical, while enabling the contribution of disparate standpoints to the production of scientific knowledge. Conclusions: The implications of presumed objectivity and representational authority demand a reconsideration of how research in vulnerable communities might be conducted, such that it produces results that are scientifically rigorous and socially responsible.

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