Challenges in receiving HIV prevention services by female sex workers: a qualitative study

Abstract

Introduction: Female sex workers (FSWs) play a considerable role in human immunodeficiency virus (HIV) prevalence. There is no comprehensive program to manage their health needs, especially HIV prevention. There are barriers and challenges, which sex workers face in accessing service provisions in healthcare centers, leading to services' under-utilization. This study was conducted to investigate these barriers and challenges that hinder the supportive and consultative care of female sex workers in Iran. Material and methods:The present study was conducted in Tehran, the capital of Iran, using a phenomenological approach. Data were collected through in-depth semi-structured interviews among twenty-two female sex workers. Interviews were transcribed verbatim, and analyzed according to qualitative content analysis based on Colizzi's seven-stage method.Results: Three main themes and seven sub-themes emerged from the collected data. Finding out about and attending healthcare center, perceived benefits and barriers, and challenges to using the services emerged as themes. Sub-themes included active search, referring by others, contraceptive measures, disease prevention services, economic aspects, systemic barriers, honor-related concerns, and stigmatization.Conclusions: FSWs actively searched for healthcare centers or were referred to them due to increasing public awareness on HIV. Concerns regarding disease preventative measures and cost-effectiveness of such measures were some of the considerable perceived benefits of healthcare centers that encouraged female sex workers to attend these centers. Barriers included both systemic and honor-related concerns, and highlighted the importance of structural modification and staff training to create a safe space, and provide unbiased attitudes in the treatment of such patients.