Division of Global Public Health, University of California, La Jolla, CA, USA.
Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
Int J Gynaecol Obstet. 2018 Oct;143(1):37-43. doi: 10.1002/ijgo.12441. Epub 2018 Feb 2.
To explore international migrant sex workers' experiences and narratives pertaining to the unmet need for and access to sexual and reproductive health (SRH) at the Mexico-Guatemala border.
An inductive qualitative analysis was conducted based on ethnographic fieldwork (2012-2015) including participant observation and audio-recorded in-depth interviews. The participants were female sex workers aged 18 years or older and international migrants working at the Mexico-Guatemala border.
In total, 31 women were included. The greatest areas of unmet need included accessible, affordable, and nonstigmatizing access to contraception and treatment of sexually transmitted infections. On both sides of the border, poor information about the health systems, services affordability, and perceived stigma resulted in barriers to access SRH services, with women preferring to access private doctors in their destination country or delaying uptake of until their next trip home. Financial barriers prevented women from accessing needed services, with most only receiving SRH services in their destination country through public health regulations surrounding sex work or as urgent care.
There is a crucial need to avoid prioritizing vertical disease-specific services and to promote access to rights-based SRH services for migrant sex workers in both home and destination settings.
探讨墨西哥-危地马拉边境地区国际移民性工作者在性健康和生殖健康(SRH)方面未满足的需求和获得途径的经验和叙述。
基于 2012 年至 2015 年期间的人种学实地调查(包括参与式观察和录音的深入访谈)进行了归纳定性分析。参与者为年龄在 18 岁及以上的在墨西哥-危地马拉边境工作的女性性工作者和国际移民。
共有 31 名女性被纳入研究。最大的未满足需求领域包括获得负担得起且非污名化的避孕和性传播感染治疗的途径。在边境两侧,对卫生系统、服务可负担性和感知污名的了解不足导致了获取 SRH 服务的障碍,妇女更愿意在目的地国寻求私人医生或在下一次回家旅行时才延迟接受治疗。经济障碍使妇女无法获得所需的服务,大多数妇女只能通过与性工作相关的公共卫生法规或紧急护理在目的地国家获得 SRH 服务。
迫切需要避免优先考虑垂直的特定疾病服务,并促进移民性工作者在原籍国和目的地国获得基于权利的 SRH 服务。