Communication Strategies To Enhance HIV/STI Prevention, Sexual and Reproductive Health, and Safety Among Migrant Sex Workers at the Mexico-Guatemala Border.

Communication-based interventions have been linked to improved health and social outcomes among underserved populations. Migrant women in sex work face serious health and social inequities, including risks of HIV and other sexually transmitted infections (STIs) and violence. Given gaps in evidence about health communication among migrant sex workers and the potential for communication-based interventions to promote health and safety, this qualitative study investigates experiences with accessing and sharing information regarding HIV/STI prevention, sexual and reproductive health, and physical safety among migrant sex workers at the Mexico-Guatemala border. Findings suggest that participatory peer-based, workplace, and m-health communication interventions could facilitate access to HIV/STI prevention, and to sexual and reproductive health/safety resources for migrant women involved in sex work, while strengthening peer support networks and social cohesion. To have long-lasting results, such interventions must be complemented by broader structural changes, including sex work and migration law reforms, increased community mobilization, and improved working conditions.

Enhancing the Ethical Conduct of HIV Research with Migrant Sex Workers: Human Rights, Policy, and Social Contextual Influences.

BACKGROUND: Migrant sex workers are often highly marginalized and disproportionately experience health and social inequities, including high prevalence of HIV, sexually transmitted infections, and human rights violations. In recent years, research involving migrant sex workers has increased, yet many knowledge gaps remain regarding how best to protect research participant rights and welfare. Our objective was to identify key challenges and opportunities related to the responsible conduct of HIV research with migrant sex workers. METHODS: Focus groups and interviews conducted with 33 female sex workers ≥18 years old at the Guatemala-Mexico border from June 2013-February 2014 were analyzed. Participants were recruited through community outreach by a local HIV prevention organization to sex work establishments such as bars, hotels, street corners, and truck stops. RESULTS: Key themes influencing research engagement for migrant sex workers included researcher mistrust and fear related to research participation, rooted in the social isolation frequently faced by recent migrants; intersecting concerns related to immigration status, fear of criminalization, and compliance with sex work regulations; and perceived benefits and risks of HIV/STI testing for migrants (e.g., immigration implications, stigma) represent potential barriers and opportunities for the responsible conduct of research involving migrant sex workers. CONCLUSIONS: Results highlight the intersection between the human rights vulnerabilities of migrant sex workers and barriers to research participation, including social isolation of migrants and policy/legal barriers related to immigration and sex work. Findings illustrate the need for researchers to develop population-tailored procedures to address fears related to immigration and criminalization, and to reinforce positive and non-stigmatizing relationships with migrant sex workers. Community-led efforts to reduce stigma and foster community organization and supports for migrant sex workers are recommended, as are broader policy shifts that move away from punitive legal approaches towards approaches that safeguard and prioritize the human rights of migrant sex workers.

Structural and Interpersonal Benefits and Risks of Participation in HIV Research: Perspectives of Female Sex Workers in Guatemala.

This study explored perceived benefits and risks of participation in HIV research among 33 female sex workers in Tecun Uman, Guatemala. Stigma associated with sex work and HIV was a critical barrier to research participation. Key benefits of participation included access to HIV/STI prevention and testing, as well as positive and trusting relationships between sex workers and research teams. Control exerted by managers had mixed influences on perceived research risks and benefits. Results underscore the critical need for HIV investigators to develop population-tailored procedures to reduce stigma, engage managers, and reinforce trusting, reciprocal relationships between sex work communities and researchers.