Beckham Sarah W, Shembilu Catherine R, Brahmbhatt Heena, Winch Peter J, Beyrer Chris, Kerrigan Deanna L
Postdoctoral Fellow, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and can receive mail at P.O. Box 1441, Iringa, Tanzania.
Stud Fam Plann. 2015 Mar;46(1):55-71. doi: 10.1111/j.1728-4465.2015.00015.x.
Understanding the pregnancy experiences of female sex workers (FSWs), especially in the context of high rates of HIV and sexually transmitted infections (STIs), is essential to tailoring services to meet their needs. This study explores FSWs' experiences with intended pregnancy and access to antenatal care and HIV testing in two regions of Tanzania. Thirty in-depth interviews and three focus group discussions were conducted. FSWs sought to become pregnant to gain respect as mothers, to avoid stigma, and/or to solidify relationships, sometimes posing risks to their own and their partners' health. Pregnant FSWs generally sought antenatal care (ANC) services but rarely disclosed their occupation, complicating provision of appropriate care. Accessing ANC services presented particular challenges, with health care workers sometimes denying all clinic services to women who were not accompanied by husbands. Several participants reported being denied care until delivery. The difficulties participants reported in accessing health care services as both sex workers and unmarried women have potential social and health consequences in light of the high levels of HIV and STIs among FSWs in sub-Saharan Africa.
了解女性性工作者（FSW）的怀孕经历，尤其是在艾滋病毒和性传播感染（STIs）高发的背景下，对于提供满足她们需求的服务至关重要。本研究探讨了坦桑尼亚两个地区女性性工作者的意外怀孕经历以及获得产前护理和艾滋病毒检测的情况。研究进行了30次深入访谈和3次焦点小组讨论。女性性工作者试图怀孕以获得作为母亲的尊重、避免耻辱和/或巩固关系，有时这会对她们自己和伴侣的健康构成风险。怀孕的女性性工作者通常会寻求产前护理（ANC）服务，但很少透露自己的职业，这使得提供适当护理变得复杂。获得产前护理服务面临特殊挑战，医护人员有时会拒绝为没有丈夫陪同的女性提供所有诊所服务。几名参与者报告说在分娩前一直被拒绝护理。鉴于撒哈拉以南非洲女性性工作者中艾滋病毒和性传播感染的高发病率，参与者作为性工作者和未婚女性在获得医疗服务方面遇到的困难可能会产生社会和健康后果。
