Access to healthcare for long-term conditions in women involved in street-based prostitution: a qualitative study

Abstract

BackgroundWomen involved in street-based prostitution (SBP) have well-documented health problems specific to their occupation, but access to care for other chronic health problems has not been explored. Primary care is seen as the optimal context to deliver care for people with long-term conditions because it is accessible, efficient, and can tackle inequalities related to socioeconomic deprivation. We aimed to explore the perspectives of women involved in SBP about access to health care for their long-term conditions.MethodsThis was a qualitative study with women accessing a third sector organization in North West England. Semi-structured interviews were conducted with sixteen women involved in SBP and accessing support. Data were analysed using the principles of constant comparison and a framework approach.ResultsWomen described how they were living with ill health, which they found difficult to manage, and often impacted on their work. Women reported poor access to care and viewed any ensuing consultations in primary care as unsatisfactory.ConclusionThis study highlights the unmet health needs of women who work in SBP, not just related to their occupation, but due to their co-morbid long-term conditions. Access to primary care was reported to be problematic and interactions with general practitioners not fulfilling their expectations, which impacted on future consultation behaviour. Understanding the health-seeking behaviours and self-management strategies of women involved in SBP with chronic health problems is essential in the design and commissioning of services and may reduce unscheduled care in this under-served group.

Experiences of commercial sex workers during COVID-19 restrictions in selected metropolises in Ghana

“…Evidence exists that CSWs are at heightened risk of ill health (Mastrocola et al, 2015), substance misuse and violence (Deering et al, 2014), during crisis situations as they become frustrated and sometimes depressed. Leaders of some CSWs groups in the study area have criticized the Government's lack of action to protect their health and social needs during the pandemic since they held the perception that the government was just insensitive to their needs at this crucial time that their livelihood has been significantly affected by the pandemic and its associated restrictions.…”

Covid-19: Health needs of sex workers are being sidelined, warn agencies

“…Sex workers are at heightened risk of ill health,1 substance misuse, and violence,2 said the ECP, and unless the services they rely on resume normal operation soon and sex workers’ financial hardship is tackled, their health problems will multiply.…”

How can general practice respond to the needs of street-based prostitutes?

“…'Fund outreach programmes to help often excluded groups such as those with mental health problems, learning disabilities and the homeless to access general practice.' Few women in our study 10 reflected positively on relationships with general practice, or described an ongoing therapeutic relationship with one supportive GP. Primary care was failing these women.…”

“…2 Women involved in SBP also suffer physical, as well as the better documented psychosocial, comorbidities. 10 We reported that women involved in SBP have poor knowledge of their physical conditions and how to optimally manage them. Their chaotic lifestyle, and limited perceptions of the seriousness of their health problems, resulted in help-seeking at a time of crisis and often resorting to the use of unscheduled care.…”