a Department of Health, Behavior & Society, The Johns Hopkins Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD , USA.
b Department of Health Behavior , The University of North Carolina Gillings School of Global Public Health , Chapel Hill , NC , USA.
Glob Public Health. 2018 Aug;13(8):1020-1034. doi: 10.1080/17441692.2017.1342850. Epub 2017 Jun 26.
Female sex workers (FSWs) are disproportionately affected by HIV, but there is limited research on their HIV care experiences. This study explored the experiences of 44 FSWs living with HIV in Santo Domingo, Dominican Republic along the HIV care continuum using in-depth interviews and focus groups. Data were analysed through narrative and thematic analysis. Individual-level factors that facilitated engagement in HIV care were physical and mental health. At the interpersonal level, disclosure of HIV or sex work status and receipt of emotional and economic support were important influences on engagement. Yet, negative reactions to or lack of disclosure of these statuses compromised engagement, further highlighting the role of stigma and discrimination. At the environmental level, FSWs described considerable challenges with the health system including long waits and treatment stock-outs at their clinics, but were generally satisfied with HIV clinic staff. At the structural level, lack of economic resources complicated care and treatment adherence. Findings underscore the need for psychosocial and economic support tailored to the unique needs of FSWs to maximise the individual and public health benefits of HIV care.
女性性工作者（FSWs）受到 HIV 的影响不成比例，但关于她们的 HIV 护理经验的研究有限。本研究使用深入访谈和焦点小组，探讨了在多米尼加共和国圣多明各与 HIV 护理连续体一起生活的 44 名 HIV 阳性 FSW 的经历。数据通过叙述和主题分析进行分析。促进 HIV 护理参与的个体因素是身心健康。在人际层面上，HIV 或性工作状况的披露以及获得情感和经济支持对参与产生重要影响。然而，对这些状况的负面反应或缺乏披露会影响参与，进一步凸显了耻辱感和歧视的作用。在环境层面上，FSWs 描述了卫生系统面临的诸多挑战，包括她们的诊所长时间等待和治疗药物短缺，但对 HIV 诊所工作人员普遍感到满意。在结构层面上，缺乏经济资源使护理和治疗依从性变得复杂。研究结果强调需要针对 FSW 的独特需求提供社会心理和经济支持，以最大限度地提高 HIV 护理对个人和公共健康的益处。
