New York City Department of Health and Mental Hygiene, USA.
SAHARA J. 2010 Aug;7(2):52-61. doi: 10.1080/17290376.2010.9724957.
The aim of the study was to examine and describe the individual and structural-environmental factors that shape the vulnerability of brothel-based female sex workers (FSWs) in Ibadan, southwest Nigeria to HIV infection. A descriptive qualitative research design was utilised to elicit data, using in-depth interviews and focus group discussions, from 60 randomly selected participants in four brothels. A thematic analysis of data was undertaken following transcription and validation of interviews. Five themes emerged from the data: (i) flawed knowledge and fatalistic attitudes; (ii) the psychosocial and economic context of sex work; (iii) religious beliefs, stigma and risk taking; (iv) barriers to HIV testing; and (v) legal and policy constraints to sex work. We describe the complex interaction between these themes and how they combine to increase the risk of HIV infection among FSWs. The impact of previous interventions to reduce the risk of HIV infection among FSWs has been limited by personal and structural factors; hence we recommend that new strategies that recognise the practical constraints to HIV prevention among FSWs are urgently needed to make the environment of commercial work safer for FSWs, their clients, and by extension the general population.
本研究旨在探讨和描述个体和结构-环境因素,这些因素塑造了尼日利亚西南部伊巴丹妓院女性性工作者(FSW)感染 HIV 的脆弱性。采用描述性定性研究设计,从四个妓院中随机抽取 60 名参与者进行深入访谈和焦点小组讨论,以获取数据。对访谈进行转录和验证后,对数据进行主题分析。数据中出现了五个主题:(i)有缺陷的知识和宿命论态度;(ii)性工作的社会心理和经济背景;(iii)宗教信仰、耻辱感和冒险行为;(iv)艾滋病毒检测障碍;以及(v)性工作的法律和政策限制。我们描述了这些主题之间的复杂相互作用,以及它们如何共同增加 FSW 感染 HIV 的风险。以前为降低 FSW 感染 HIV 的风险而采取的干预措施受到个人和结构因素的限制;因此,我们建议迫切需要采取新的策略,以认识到 FSW 中 HIV 预防的实际限制,使商业工作环境对 FSW 及其客户,以及更广泛的公众更安全。