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1.
Invest. educ. enferm ; 38(1): [E03], febrero 15 2020. Fig 1, Fig 2, Fig 3
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1051485

RESUMO

Objective. To know the social representations of female sex workers about their sexuality. Methods. Qualitative study based on the Theory of Social Representations. Thirty-nine women from a health region of Alto Sertão Produtivo Baiano - Brazil agreed to participate. For the production of empirical data, the techniques of Free Word Association and in-depth interviews were used. The answers were analyzed based on Constellation Target Content Analysis and Semantic Content Analysis. Results. Two thematic categories emerged: "negative representation of sexuality"; "my pleasure is the money". Therefore, the theme sexuality and meanings derived from the social representations elaborated by the sex workers about sexuality, based on their experiences and daily life, showed that the work involved a negative representation of sexuality when associated with sexual satisfaction with the client, in addition to the allusion to sex as a source of income. Conclusion. The social representations about sexuality constructed by sex workers are linked to the feeling of denial of pleasure and obtaining money for subsistence. Reflecting on sexuality points out ways to rethink the care to be provided for a stigmatized and vulnerable group.


Objetivo. Apreender las representaciones sociales de las trabajadoras sexuales sobre su sexualidad. Métodos. Estudio cualitativo, basado en la Teoría de las Representaciones Sociales. Aceptaron participar 69 mujeres de una región productiva bahiana de salud en el Sertão (Brasil). Para la producción de los datos empíricos, se utilizaron las técnicas de Asociación Libre de Palabras y entrevistas a profundidad. Las respuestas se analizaron a partir del Análisis de Contenido por Objetivo de Constelación o de Contenido Semántico. Resultados. Surgieron dos categorías temáticas: "Representación negativa de la sexualidad" y "Mi placer es el dinero". Para las trabajadoras sexuales, la sexualidad tiene una representación negativa cuando se asocia con la satisfacción sexual con el cliente, además de la alusión al sexo como fuente de ingreso económico. Conclusión. Las representaciones sociales de la sexualidad construidas por las trabajadoras sexuales se refieren al sentimiento de negación del placer y a la obtención de dinero para la subsistencia. Reflexionar sobre la sexualidad aporta caminos para repensar el cuidado a un grupo estigmatizado por la sociedad y con alta vulnerabilidad social


Objetivo. Apreender as representações sociais de trabalhadoras sexuais sobre sua sexualidade. Métodos. Estudo qualitativo, fundamentado na Teoria das Representações Sociais. Aceitaram participar 69 mulheres de uma região de saúde do Sertão Produtivo Baiana (Brasil). Para a produção dos dados empíricos utilizou-se as técnicas de Associação Livre de Palavras, e a entrevista em profundidade. As respostas foram analisadas a partir da Análise de Conteúdo por Alvo de Constelação e de Conteúdo Semântica. Resultados. Surgiram duas categorias temáticas: "representação negativa da sexualidade" e "meu prazer é o dinheiro". Para as trabalhadoras sexuais, a sexualidade envolve a representação negativa quando associado à satisfação sexual com o cliente, além da alusão ao sexo como fonte de renda. Conclusão. As representações sociais sobre a sexualidade construídas por trabalhadoras sexuais remetem ao sentimento de negação do prazer e a obtenção do dinheiro para a subsistência. Refletir sobre a sexualidade apontam caminhos para repensar o cuidado a um grupo estigmatizado e de vulnerabilidade pela sociedade.


Assuntos
Humanos , Comportamento Sexual , Mulheres , Sexualidade , Pesquisa Qualitativa , Prazer , Profissionais do Sexo
2.
MMWR Morb Mortal Wkly Rep ; 69(8): 212-215, 2020 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-32107367

RESUMO

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the largest bilateral funder of human immunodeficiency virus (HIV) prevention and control programs worldwide, currently supports implementation of preexposure prophylaxis (PrEP) to reduce HIV incidence among persons at substantial risk for infection, including female sex workers, men who have sex with men (MSM), and transgender women (hereafter referred to as key populations). Recent estimates suggest that 54% of all global new HIV infections in 2018 occurred among key populations and their sexual partners (1). In 2016, PEPFAR began tracking initiation of PrEP by key populations and other groups at high risk (2). The implementation and scale-up of PrEP programs across 35 PEPFAR-supported country or regional programs* was assessed by determining the number of programs reporting any new PrEP clients during each quarter from October 2016 to September 2018. As of September 2018, only 15 (43%) PEPFAR-supported country or regional programs had implemented PrEP programs; however, client volume increased by 3,351% over the assessment period in 15 country or regional programs. Scale-up of PrEP among general population clients (5,255%) was nearly three times that of key population clients (1,880%). Among key populations, the largest increase (3,518%) occurred among MSM. Factors that helped drive the success of these PrEP early adopter programs included initiation of national, regional, and multilateral stakeholder meetings; engagement of ministries of health and community advocates; revision of HIV treatment guidelines to include PrEP; training for HIV service providers; and establishment of drug procurement policies. These best practices can help facilitate PrEP implementation, particularly among key populations, in other country or regional programs to reduce global incidence of HIV infection.


Assuntos
Infecções por HIV/prevenção & controle , Cooperação Internacional , Profilaxia Pré-Exposição/organização & administração , Desenvolvimento de Programas , Feminino , Saúde Global/estatística & dados numéricos , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Profissionais do Sexo , Pessoas Transgênero , Estados Unidos
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(1): 85-89, 2020 Jan 10.
Artigo em Chinês | MEDLINE | ID: mdl-32062948

RESUMO

Objective: To assess the quality of data of intervention in population at high risk for HIV/AIDS, especially in female sex workers (FSWs) and men who have sex with men (MSM), in China during 2014-2018, for the purpose of improving intervention data quality. Methods: Data accuracy was evaluated by sampling monthly reported intervention data and comparing the consistency of the information recorded in national HIV/AIDS prevention and treatment information system to original paper records. Data authenticity was assessed by visiting intervention sites and interviewing owners, manager and/or target groups at sites. The assessment results of both national level and provincial level were summarized by year and analyzed with descriptive statistical method. The data quality problems recognized by assessments were summed up. Results: The annual concordance rate of the data recorded in information system to paper records was 94.6%(17 671/18 673) in provincial level assessment and 79.4%(558/703) in national level assessment. Up to 81.6%(8 617/10 559) and 84.4% (249/295) of all sampled intervention sites were annually evaluated as "good" in provincial and state level assessments respectively. The assessment found that the intervention data in original paper records were not completely consistent to that recorded in the information system, the deficiency of ability on intervention data management, and the insufficient coverage and effect of intervention service influenced the intervention data quality. Conclusions: In general, the accuracy and authenticity of intervention data were fine in China during 2014-2018. Intervention data quality can be improved through measures of enhancing data quality management, strengthening training for the prevention and intervention in FSWs and MSM, and providing high- quality intervention service.


Assuntos
Confiabilidade dos Dados , Infecções por HIV , Minorias Sexuais e de Gênero , China , Feminino , HIV , Infecções por HIV/prevenção & controle , Infecções por HIV/terapia , Homossexualidade Masculina , Humanos , Masculino , Profissionais do Sexo
4.
REVISA (Online) ; 9(1): 53-64, jan-mar.2020.
Artigo em Inglês, Português | LILACS | ID: biblio-1050846

RESUMO

Objetivo: Este estudo teve como objetivo descrever os itinerários terapêuticos e rotas críticas desveladas no discurso de profissionais do sexo quanto ao acesso à saúde. Método: Trata-se de um estudo descritivo, exploratório, qualitativo, realizado em uma casa de prostituição, com 12 mulheres profissionais do sexo. Realizou-se entrevistas, analisadas sob o método do Discurso do Sujeito Coletivo. Resultados: Os itinerários revelam práticas de cuidados desempenhas a partir das experiências individuais, sendo a busca por cuidados profissionais em saúde, realizadas no setor privado, decorrente da agilidade no atendimento, diminuição da exposição e estigmas. Rotas críticas emergiram a partir do afastamento das profissionais dos serviços públicos de saúde, tal como da vivência de situações vulneráveis. Conclusão: Os itinerários terapêuticos estão permeados por práticas de cuidado individual, autônomo e da busca por atenção à saúde privada, com apresentação de rotas críticas decorrentes da vulnerabilidade à violência e infecções.


Objective: This study aimed to describe the therapeutic itineraries and critical routes unveiled in the discourse of sex workers regarding access to health. Method: This is a descriptive, exploratory, qualitative study conducted in a prostitution house with 12 female sex workers. Interviews were conducted, analyzed under the Collective Subject Discourse method. Results: The itineraries reveal care practices performed from individual experiences, and the search for professional health care, carried out in the private sector, due to agility in care, decreased exposure and stigmas. Critical routes emerged from the removal of professionals from public health services, as well as the experience of vulnerable situations. Conclusion: The therapeutic itineraries are permeated by practices of individual, autonomous care and the search for attention to private health, presenting critical routes resulting from vulnerability to violence and infections.


Objetivo: Este estudio tuvo como objetivo describir los itinerarios terapéuticos y las rutas críticas reveladas en el discurso de las trabajadoras sexuales sobre el acceso a la salud. Método: Este es un estudio descriptivo, exploratorio y cualitativo realizado en una casa de prostitución con 12 trabajadoras sexuales. Se realizaron entrevistas, analizadas bajo el método de Discurso del sujeto colectivo. Resultados: Los itinerarios revelan prácticas de atención realizadas a partir de experiencias individuales y la búsqueda de atención médica profesional, realizada en el sector privado, debido a la agilidad en la atención, la disminución de la exposición y los estigmas. Las rutas críticas surgieron de la eliminación de profesionales de los servicios de salud pública, así como de la experiencia de situaciones vulnerables. Conclusión: Los itinerarios terapéuticos están impregnados por prácticas de atención individual y autónoma y la búsqueda de atención a la salud privada, presentando rutas críticas resultantes de la vulnerabilidad a la violencia y las infecciones.


Assuntos
Profissionais do Sexo
6.
Gesundheitswesen ; 82(2): 157-162, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31822025

RESUMO

On July 1, 2017 the German sex workers protection act came into force. Numerous institutions and groups expressed their disagreement towards this action in preceding discussions. A major criticism was the underlying one-sided understanding of prostitution and on the dilution of protective spaces for sex workers resulting from control by the authorities. Nevertheless, the law was adopted. Legal basis As the act is to be implemented by municipalities, the federal states were obliged to implement the laws. In the federal state of Saxony, the adoption was delayed considerably, since initially it was unclear which department had the responsibility to implement the law. Furthermore, there was a long-lasting political need for clarification regarding the burden of additional finances on municipalities. Only on July 26, 2018 was the sex workers protection act implemented in the federal state of Saxony. Experiences In the city of Dresden, structural conditions were established, allowing a clear separation between the processes of health counselling by the Public Health Office and the registration of the sex workers by the Public Order Office. Also, the different services of the Public Health Office are kept physically separate due to competing federal laws. Simultaneously, a new specialist area was created including both counselling centres, which thus prevents different standards in the services provided for sex workers within the Public Health Office. Whether the sex workers protection act serves the intended purpose may be doubted. The city of Dresden has made an attempt to counteract the negative consequences of the law by implementing clear structures and internal standards.


Assuntos
Saúde Pública , Profissionais do Sexo , Cidades , Alemanha , Humanos , Legislação como Assunto , Profissionais do Sexo/legislação & jurisprudência
7.
AIDS Behav ; 24(2): 506-515, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31865516

RESUMO

Transgender female sex workers (TFSW) are highly affected by HIV, with a global prevalence of 27%. HIV self-testing (HIVST) to screen sexual partners has helped men who have sex with men and female sex workers make informed sexual decisions and avoid HIV exposure. This is the first report on TFSW's experiences screening clients using HIVST. Ten TFSW were each given ten HIVST kits and returned after 3 months to complete an online questionnaire and undergo an interview. Eight of them reported using HIVST with potential partners. Among fifty potential partners who were asked in person to test, 42 (84%) were clients. Thirty-four out of fifty (68%) accepted and 16 (32%) refused. Very few violent incidents occurred, and participants felt empowered by offering HIVST to others. Nevertheless, HIVST market cost was prohibitive for future use. HIVST use with clients could be feasible for TFSW if the cost were lowered or subsidized.


Assuntos
Sorodiagnóstico da AIDS/métodos , Infecções por HIV/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Autocuidado/métodos , Autoexame/estatística & dados numéricos , Profissionais do Sexo/psicologia , Parceiros Sexuais , Pessoas Transgênero/psicologia , Adulto , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , New York/epidemiologia , Prevalência , Porto Rico/epidemiologia , Autocuidado/psicologia , Comportamento Sexual , Inquéritos e Questionários
8.
Rev Lat Am Enfermagem ; 27: e3226, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31826167

RESUMO

OBJECTIVE: to analyze the factors associated to the inconsistent condom use among sex workers. METHOD: a transversal study, carried out in prostitution area, using the Respondent Drive Sampling. The sample was calculated based on the information by the Sex Workers Association: 600 female sex workers. The study selected seven women with different characteristics regarding color, age, and place of work, who were called seeds. After the participation, they received three coupons to recruit other participants in order to obtain a representative sample. The definition of inconsistent condom use was determined as occasional use or never using it. Univariate analyses and a multivariate logistic regression were performed. RESULTS: 416 female sex workers participated in the study. The associated factors were having studied for less than eight years (Odds Ratio = 27.28), not having a permanent partner (Odds Ratio = 2.79), high alcohol use (Odds Ratio = 5.07), and being black (Odds Ratio = 2.21). CONCLUSION: the factors associated to inconsistent condom use were: lower education levels, not having a permanent partner, high alcohol use, and being black.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Trabalho Sexual/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Consumo de Bebidas Alcoólicas , Atitude Frente a Saúde , Brasil , Estudos Transversais , Feminino , Humanos , Trabalho Sexual/etnologia , Comportamento Sexual , Fatores Socioeconômicos , Adulto Jovem
10.
BMC Health Serv Res ; 19(1): 801, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694616

RESUMO

BACKGROUND: While there are indications of declining HIV infection rates in the general population globally, Tanzania included, men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID), now called Key Populations (KP) for HIV epidemic have 2-20 times higher infections rates and contributes up to 30% of new HIV infection. Tanzania have developed a Comprehensive Guideline for HIV prevention among key population (CHIP) to address the epidemic among KPs. However, these populations are stigmatized and discriminated calling for innovative approaches to improve access to CHIP. This project seeks to test the effectiveness of healthcare workers and peer-to-peer engagement in promoting access to CHIP among HIV at risk populations in Tanzania. METHODS: A quasi-experimental design involving Dar es Salaam City as an intervention region and Tanga as a control region will be done. Using respondent driven sampling, 1800 at risk population (900 from Intervention site and 900 from control site) will be recruited at baseline to identify pull and push factors for health services access. Stakeholder's consultation will be done to improve training contents for CHIP among health care workers and peers. Effectiveness of healthcare workers training and peer engagement will be tested using a quasi-experimental design. DISCUSSION: The results are expected to co-create service provision and improve access to services among KPs as a human right, reverse HIV infection rates among KPs and the general population, and improve social and economic wellbeing of Tanzanian. TRIAL REGISTRATION: Retrospectively registered on 28th August, 2019 with International Standard Randomized Clinical Trial Number ( ISRCTN11126469 ).


Assuntos
Infecções por HIV/prevenção & controle , Pessoal de Saúde , Promoção da Saúde , Profissionais do Sexo/educação , Assistência à Saúde , Infecções por HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Grupo Associado , Fatores de Risco , Abuso de Substâncias por Via Intravenosa , Tanzânia/epidemiologia
11.
BMC Health Serv Res ; 19(1): 799, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690299

RESUMO

INTRODUCTION: Female Sex workers (FSW) and their clients accounted for 18% of the new HIV infections in 2015/2016. Special community-based HIV testing service delivery models (static facilities, outreaches, and peer to peer mechanism) were designed in 2012 under the Most At Risk Populations Frame work and implemented to increase access and utilization of HIV care services for key populations like female sex workers. However, to date there is no study that has been done to access the preference and uptake of different community-based HIV testing service delivery models used to reach FSW. We assessed preference and uptake of the current community-based HIV testing services delivery models that are used to reach FSW and identified challenges faced during the implementation of the models. METHODS: We conducted a cross-sectional study design using quantitative (interview with the health workers in facilities providing services to female sex workers and interviews with FSWs) and qualitative (interviews with Ministry of Health staff, health workers, district health team members, program staff at different levels involved in delivery of HIV care services, FSWs and political leaders to assess for the enabling environment created to deliver the different community-based HIV testing services to FSWs along the Malaba-Kampala highway. Malaba - Kampala high way is one of the major high ways with many different hot spots where the actual buying and selling of sex takes place. We defined FSWs as any female, who undertakes sexual activity after consenting with a man for money or other items/benefits as an occupation or as a primary source of livelihood irrespective of site of operation within the past six months. We assessed the preference and uptake of different community based HIV testing services delivery model among FSWs based on two indicators, i.e., the proportion of FSWs who had an HIV Counseling and Testing (HCT) in the last 12 months and the proportion of FSWs who were positive and linked to care. RESULTS: Overall, 86% (390/456) of the FSWs had taken an HIV test in the last 12 months. Of the 390 FSWs, 72% (279/390) had used static facilities, 25% (98/390) had used outreaches, and 3.3% (13/390) used peer to peer mechanisms to have an HIV test. Overall, 35% (159/390) of the FSWs who had taken an HIV test were HIV positive. Of the 159, 83% (132/159) were successfully linked into care. Ninety one percent (120/132) reported to have been linked into care by static facilities. Challenges experienced included; lack of trust in the results given during outreaches, failure to offer other testing services including hepatitis B and syphilis during outreaches, inconsistent supply of testing kits, condoms, STI drugs, and unfriendly health services due to the infrastructure and non-trained health workers delivering KP HIV testing services. CONCLUSIONS: Most of the FSWs had HCT services and were linked to care through static facilities. Community-based HIV testing service delivery models are challenged with inconsistent supply of HIV testing commodities and unfriendly services.. We recommended strengthening of all HIV testing community-based HIV testing service deliverymodels by ensuring constant supply of HIV testing/AIDS care commoditiesoffering FSW friendly services, and provision of comprehensive HIV/AIDS health care package.


Assuntos
Infecções por HIV/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Preferência do Paciente/estatística & dados numéricos , Profissionais do Sexo/psicologia , Adolescente , Adulto , Serviços de Saúde Comunitária/organização & administração , Estudos Transversais , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Profissionais do Sexo/estatística & dados numéricos , Uganda , Adulto Jovem
13.
Afr J Reprod Health ; 23(3): 79-95, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31782634

RESUMO

The aim of the study was to evaluate the psychometric properties of the London Measure of Unplanned Pregnancy (LMUP) among female sex workers (FSWs) in Uganda. The LMUP was translated into Luganda and adapted for use with FSWs and underwent cognitive testing and two field tests. From the final Luganda LMUP, three other language versions were created (Acholi, Lugisu and Runyakole), and preliminary field test data were collected. Final data were collected from 819 FSWs attending the 'Most at Risk Population Initiative' clinics. The Luganda field testing showed that there were no missing data, the scale was well targeted, Cronbach's alpha was 0.82, weighted Kappa was 0.78, measurement was unidimensional, and all construct validity hypotheses were met. Likewise, with the Acholi, Lugisu, and Runyankole translations, field testing showed that there were no missing data, the scales were well targeted, Cronbach's alpha were<0.70, and measurement was unidimensional. We concluded that the Luganda LMUP is a valid and reliable tool for assessing pregnancy planning among FSWs in Uganda and that the Acholi, Lugisu, and Runyankole versions of the LMUP also had good initial psychometric properties.


Assuntos
Intenção , Gravidez não Planejada/psicologia , Psicometria/estatística & dados numéricos , Profissionais do Sexo/psicologia , Inquéritos e Questionários/normas , Adulto , Feminino , Humanos , Masculino , Gravidez , Reprodutibilidade dos Testes , Tradução , Uganda
14.
Afr J AIDS Res ; 18(3): 215-223, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31575341

RESUMO

Female sex workers (FSW) in mining sites are considered to be at very high risk of HIV infection. We aimed to characterize FSW at the Kôkôyô artisanal gold mining site in Mali, and identify factors associated with sex work using data from ANRS-12339 Sanu Gundo, a cross-sectional survey conducted in 2015 at the mine by ARCAD-SIDA, a Malian non-governmental organisation. People attending HIV-prevention activities were invited to participate in the quantitative and qualitative parts of the survey. A probit logistic regression was used for data analysis. Of 101 women who participated in the survey, 26.7% reported sex work as their main activity. Multivariate analysis showed that the probability of sex work as a main activity decreased by 1% per 1-year age increase (p = 0.020). Sex work was significantly more likely to be reported by single, divorced and widowed women (25.4% probability; p = 0.007). FSW were significantly more likely to be non-Malian (36.3% probability; p = 0.003), more likely to have a secondary activity (77% probability; p = 0.002), to work fewer than 56h/week (40.2% probability; p = 0.001) and to be in good health (12.1% probability; p = 0.016). In addition, being aware of the existence of sexually transmitted infection, using psychoactive substances, and having unprotected receptive anal sex during the previous six months were significantly associated with sex work (50.2%; p = 0.006; 45.6%, p = 0.003; and 7.4%, p = 0.016 probability, respectively). Qualitative findings confirm that poverty and boyfriends' refusal to use condoms remain key barriers to systematic condom use among FSW.


Assuntos
Infecções por HIV/prevenção & controle , Sexo Seguro/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Mali , Pobreza , Prevalência , Parceiros Sexuais , Inquéritos e Questionários , Adulto Jovem
15.
Rev Bras Epidemiol ; 22Suppl 1(Suppl 1): e190002, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576978

RESUMO

INTRODUCTION: Respondent-Driven Sampling (RDS) has been used in surveys with key populations at risk of HIV infection, such as female sex workers (FSW). This article describes the application of the RDS method among FSW in 12 Brazilian cities, during a survey carried out in 2016. METHODOLOGY: A biological and behavioral surveillance study carried out in 12 Brazilian cities, with a minimum sample of 350 FSW in each city. Tests were performed for HIV, syphilis, and hepatitis B and C infections. A social-behavioral questionnaire was also applied. RESULTS: The sample was comprised of 4,328 FSW. For data analysis, the sample was weighted according to each participant's network size (due consideration to the implications of RDS complex design and to the effects of homophilia are recommended). DISCUSSION: Although RDS methods for obtaining a statistical sample are based on strong statistical assumptions, allowing for an estimation of statistical parameters, with each new application the method has been rethought. In the analysis of whole-sample data, estimators were robust and compatible with those found in 2009. However, there were significant variations according to each city. CONCLUSION: The achieved sample size was of great relevance for assessing progress and identifying problems regarding the prevention and treatment of Sexually Transmitted Infections. New RDS studies with more time and operational resources should be envisaged. This could further network development.


Assuntos
Infecções por HIV/epidemiologia , Inquéritos Epidemiológicos/métodos , Hepatite C/epidemiologia , Vigilância da População/métodos , Profissionais do Sexo/estatística & dados numéricos , Sífilis/epidemiologia , Brasil/epidemiologia , Cidades , Feminino , Humanos , Fatores de Risco , Tamanho da Amostra , Amostragem , Inquéritos e Questionários
16.
Rev Bras Epidemiol ; 22Suppl 1(Suppl 1): e190006, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576982

RESUMO

INTRODUCTION: Knowing the factors associated with periodic HIV testing among female sex workers (FSW) is essential to expand testing coverage and to broaden programs of treatment as prevention. METHODS: We used data from 4,328 FSWs recruited by the respondent-driven sampling (RDS) method in 12 Brazilian cities in 2016. Data analysis considered the complex sampling design. The prevalence of HIV testing in the last year and periodic HIV test were estimated. Factors associated with regular HIV testing were identified through logistic regression models. RESULTS: The testing coverage in the last year was 39.3%. Only 13.5% of FSW reported having performed a periodic HIV test in the last year. Among the factors associated with the higher probability of HIV testing in the last year were a better level of education, living with a partner, working indoors, consistent use of condoms, and regular use of public and private health services stood out. DISCUSSION: Periodic HIV testing allows early diagnosis and immediate treatment of cases, reducing the chances of spreading the infection to the population. However, factors such as stigma and discrimination hinder the use of regular health services. CONCLUSION: It is necessary to expand awareness campaigns, especially among FSWs with low educational level and greater vulnerability, in order to broaden the perception of risk and the importance of periodic testing, in addition to encouraging regular health care.


Assuntos
Sorodiagnóstico da AIDS/estatística & dados numéricos , Infecções por HIV/diagnóstico , Profissionais do Sexo/estatística & dados numéricos , Adolescente , Adulto , Brasil , Preservativos/estatística & dados numéricos , Escolaridade , Feminino , Serviços de Saúde/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Análise Multivariada , Comportamento Sexual , Adulto Jovem
17.
BMC Health Serv Res ; 19(1): 746, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651300

RESUMO

BACKGROUND: Globally, female sex workers (FSWs) are considered a key population group due to the high HIV prevalence. Studies show that there are various factors in some contexts that render FSWs marginalised, which limits their access to sexual reproductive health (SRH) services. Access to SRH services are particularly challenging in countries where sex work is criminalised such as is the case in South Africa. Evidently, there are alternative ways in which FSWs in this context receive non-stigmatising SRH care through non-governmental organisations. The aim of this study was to understand the functioning of these non-governmental health care services as well as to document the experiences of FSWs utilising these services. METHODS: Eleven focus group discussions were held with 91 FSWs. In addition, 21 in-depth individual interviews with researchers, stakeholders and FSWs were conducted. Interview guides were utilised for data collection. Informed consent was obtained from all participants. Data were analysed thematically. RESULTS: The FSWs expressed challenges related to SRH care access at public health facilities. The majority felt that they could not consult for SRH-related services because of stigma. The non-governmental health and advocacy organisations providing SRH services to FSWs through their mobile facilities utilising the peer approach, have done so in a way that promotes trust between FSWs and mobile health care providers. FSWs have access to tailored services, prevention materials as well as health information. This has resulted in the normalising of HIV testing as well as SRH seeking behaviours. CONCLUSION: This study has established that health and advocacy organisations have attempted to fill the gap in responding to SRH care needs of FSWs amidst intersecting vulnerabilities. FSWs' engagement with these organisations has encouraged their willingness to test for HIV. However, it is important to note that these organisations operate in urban areas, thus FSWs operating outside these areas are most likely exposed to compounding health risks and lack access to tailored services.


Assuntos
Acesso aos Serviços de Saúde , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Adulto , Atitude Frente a Saúde , Utilização de Instalações e Serviços , Feminino , Grupos Focais , Infecções por HIV/prevenção & controle , Pessoal de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Organizações/estatística & dados numéricos , Defesa do Paciente , Papel Profissional , Profissionais do Sexo/psicologia , Comportamento Sexual/psicologia , Estigma Social , África do Sul , Adulto Jovem
18.
BMC Infect Dis ; 19(1): 837, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31604430

RESUMO

BACKGROUND: Tuberculosis (TB) is a major public health problem in developing countries like Bangladesh. Female sex workers (FSWs) and their clients are active sources for spreading TB. The purpose of this study was to assess the knowledge of TB among FSWs in Rajshahi city, Bangladesh. METHODS: It was a cross-sectional study with a sample size of 225 FSWs. The knowledge on TB was measured by six different questions. Chi-square test and multinomial logistic regression model were used in this study to find the associated factors of lack of general knowledge on TB among FSWs. RESULTS: Out of 225 FSWs, 43.1, 34.7 and 22.2% came from urban, rural and slum areas respectively. More than 41% FSWs perceived that TB is a non-communicable disease. A large number of FSWs (76.4%) did not know the spread of TB. It was found that more than 90% FSWs did not have knowledge on latent TB. The χ2-test demonstrated that FSWs' education, monthly family income, age, currently marital status and sex trading place were significantly associated with their knowledge on TB. A remarkable number of FWSs (42.2%) had poor knowledge on TB. It was found that comparatively higher educated FWSs were more likely to have good or fair knowledge on TB than lower educated ones (p < 0.01). CONCLUSIONS: This study revealed that near to half of FSWs in Rajshahi city, Bangladesh had poor knowledge on TB. Public health authorities should pay due attention and adopt policy for increasing the knowledge on TB among FSWs to reduce the incidence of TB in Bangladesh. Subsequently, advocacy, communication for social mobilization program is very urgent.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Profissionais do Sexo/psicologia , Tuberculose/patologia , Adulto , Fatores Etários , Bangladesh , Estudos Transversais , Feminino , Humanos , Classe Social
19.
Artigo em Inglês | MEDLINE | ID: mdl-31614585

RESUMO

Female sex workers (FSWs) represent a high-risk population for HIV infection and transmission. In general, their fellow FSWs (peers) also play a role in their level of susceptibility to HIV/AIDS. This paper draws from interview data of 93 FSWs to construct a multi-layer FSW social network model based on their knowledge, attitude, and practice (KAP). Statistical analyses of the correlation among the three dimensions of KAP as well as their social interactions indicated that FSWs had basic knowledge of HIV/AIDS prevention but demonstrated little enthusiasm in acquiring relevant information. Their knowledge, attitude, and practice were highly positively correlated. Their attitude was more likely to be negatively influenced by their companions, while their practice was more likely to be positively affected. Besides, FSWs exhibited high homophily in KAP with their neighbors. Thus, during HIV/AIDS interventions, FSWs should receive individualized education based on their specific KAP. Considering the high level of homophily among FSWs, their propensity to be positive or negative in their KAP are significantly influenced by their companions. Making full use of peer education and social interaction-based interventions may help prevent and control the spread of HIV/AIDS.


Assuntos
Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Infuência dos Pares , Profissionais do Sexo/psicologia , Rede Social , Feminino , Infecções por HIV/prevenção & controle , Humanos
20.
Wiad Lek ; 72(9 cz 2): 1774-1780, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622265

RESUMO

OBJECTIVE: Introduction: Engaging in sex, which is obligatory associated with the extraordinary risks of harm to their own safety and physical health, can be considered as one of the variants of self-destruction. The aim is to analyze the leading descriptors and predictors of self-destructive behavior among female sex workers, on the basis of which to propose measures for their psycho-correction. PATIENTS AND METHODS: Materials and methods: The main group of the study was 135 women - female sex workers, a comparative group of 50 women who had no relation to such activities. The research methods were clinical-psychological, socio-demographic, psycho diagnostic, mathematical-statistical. RESULTS: Results: Suicidal mood was investigated as a descriptor of self-destructive behavior in female sex workers. Features of suicidal ideas and the basis of committing suicide are revealed. The motivating emotions of a suicidal act are shame, anger and resentment. Psychological protection as a mechanism for maintaining risky sexual behavior has been studied. Identified destructive forms of primitive level mechanisms of psychological defense. It was revealed that in women engaged in prostitution the overall viability is not sufficiently formed, mainly due to the low level of inclusion. The presence of sacrifice in the form of increased propensity to active victim behavior has been established. An increased tendency toward an active type of victim behavior has been established. Leading individual psychological and behavioral patterns in the genesis of self-destructive behavior in female sex workers have been identified and its clinical and psychological options have been singled out. Based on the data obtained, a program of measures for differentiated psycho-correction of self-destructive behavior among female sex workers was developed. CONCLUSION: Conclusions: As a result of work, the conceptualization of occupation of prostitution as a self-destructive behavior is grounded. The isolation of its specific pathognomonic psycho-emotional, individual psychological and behavioral features, made it possible to propose effective measures of its psycho-correction and of psycho-processing.


Assuntos
Comportamento Autodestrutivo , Profissionais do Sexo/psicologia , Suicídio , Feminino , Humanos , Ideação Suicida
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