HIV Testing and Engagement in Care among Highly Vulnerable Female Sex Workers: Implications for Treatment as Prevention Models

Abstract

Background Although emerging Treatment as Prevention models can be effective in reducing HIV incidence among high-risk populations, many HIV infected individuals remain undiagnosed or fail to engage in HIV care. Methods This study examined the factors associated with HIV testing and care among a population of substance using female sex workers. Results Recent HIV testing was associated with higher education level, having a regular health care provider or clinic, recent crack use, and higher sexual risk behaviors; HIV treatment utilization was associated with higher levels of social support, having a regular health care provider or clinic, housing stability and insurance coverage. Qualitative data revealed HIV-related stigma, denial, social isolation, and substance use as barriers to HIV testing and treatment; social support and accessibility of services were key enablers. Conclusions Improving HIV testing and linkage to treatment among female sex workers will require structural initiatives to reduce stigma and increase service seeking support.

Finding what works: Predicting health or social service linkage in drug using, African American, female sex workers in Miami, FL

“…See H.L. Surratt, O'Grady, Kurtz, Levi-Minzi, et al (2014) for a more comprehensive description of the interventions.…”

“…L. Surratt & Inciardi, 2010; H.L. Surratt, O'Grady, Kurtz, Buttram, & Levi-Minzi, 2014; H.L. Surratt, O'Grady, Kurtz, Levi-Minzi, & Chen, 2014; Ulibarri et al, 2014).…”

“…Despite these health problems, researchers conducting intervention studies among FSWs in the United States and abroad have been successful in promoting HIV prevention and reducing drug use, sexual risk behaviors, and STIs through: utilizing community level empowerment and mobilization models, STI care promotion, initiatives to increase access to sexual and other health services, and harm reduction strategies (Blanchard et al, 2013; Bungay et al, 2013; Kerrigan, Fonner, Stromdahl, & Kennedy, 2013; Reza-Paul et al, 2008; Strathdee et al, 2013; H. L. Surratt & Inciardi, 2010; H.L. Surratt, O'Grady, Kurtz, Levi-Minzi, et al, 2014).…”

Zugangsschwellen zu HIV-Test-Angeboten – Eine systematische Literaturanalyse

“…Andere Studien beschreiben analog, dass sich die Wahrscheinlichkeit eines HIV-Tests dann erhöht, wenn die Klienten um die Vorteile für die eigene Gesundheit und um die Handlungsoptionen wissen, die sich aus der Kenntnis einer HIV-Infektion ergeben [12,90,119,120,135,136]. Die Kenntnis dieser Handlungsoptionen beugt auch einer fatalistischen Grundhaltung vor, die v. a. IVD oder Sexarbeiter vom HIV-Test abhält [22,37,137]. Allerdings weisen Lorenc et al aufgrund einer Studie zum Testverhalten bei MSM darauf hin, dass auch die potentiellen Kosten eines positiven Test-Ergebnisses so wie eine kontinuierliche Behandlung und eine Veränderung des Lebensstils thematisiert werden müssen.…”

Gaps in the Hepatitis C Continuum of Care among Sex Workers in Vancouver, British Columbia: Implications for Voluntary Hepatitis C Virus Testing, Treatment and Care

“…Participants who had never tested for HCV or those whose last test was >12 months were considered to not have a recent HCV test. Explanatory variables: Based on previous studies examining correlates of uptake of HCV and HIV testing among sex workers and other vulnerable populations (26)(27)(28)(29)(30)(31)(32), a range of individual, contextual and social-structural explanatory variables were selected that were hypothesized to influence utilization of HCV testing in this particular setting. Individual-level factors examined included sociodemographic characteristics, and substance use behaviours including age (per year older), Aboriginal/Indigenous ancestry (including First Nations, Métis and Inuit peoples, yes versus no), international migration status (immigrant/migrant versus Canadian born), self-identification as sexual/gender minority (lesbian, gay, bisexual, transgender or two-spirit versus heterosexuals), baseline HIV status (positive versus negative), heavy alcohol drinking (>4 drinks per day, yes versus no), and any noninjection or injection drug use (yes versus no).…”