Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
Nigeria Institute of Medical Research, Yaba, Lagos State, Nigeria.
Afr J AIDS Res. 2022 Jul;21(2):171-182. doi: 10.2989/16085906.2022.2104169.
: To determine the proportion of women and girls living with HIV (WGLHIV) who had poor access to HIV, tuberculosis and sexual and reproductive health (SRH) services in Nigeria during the COVID-19 pandemic and associated factors. This was a cross-sectional study that recruited WGLHIV with six categories of vulnerability (sex work, transactional sex, injecting or using illegal drugs, people on the move, transgender women and people with a disability) through an online survey conducted in ten Nigerian states between june and October 2021. The associations between the limited access to HIV, tuberculosis and SRH services due to COVID-19, the categories of vulnerability and the financial and non-financial barriers to these services were determined using multivariable logistics regression analysis. Over 6 in 10, almost 2 in 10, and almost 4 in 10 WGLHIV had limited access to HIV, tuberculosis and SRH services respectively during the COVID-19 pandemic. Transgender women had 3.59 (95% CI 2.19-5.91) higher odds, women who engaged in sex work had 4.51 (95% CI 2.28-8.42) higher odds, and women who inject or use illegal drugs had 2.39 (95% CI 1.47-32.90) higher odds of facing limited access to sexual and reproductive health services when it was needed. In addition, the direct consequences of the COVID-19 crisis, such as the closure of HIV services and SRH service points, exacerbated pre-existing barriers significantly. Having no money, having to pay additional unofficial fees and the lack of security on the road to the health facility were the barriers with the greatest impact on access to health services. The COVID-19 pandemic had a negative impact on the access of WGLHIV to essential health services. This impact was disproportionately higher for marginalised groups. WGLHIV need non-discriminatory and affordable access to essential health services during the pandemic.
为了确定在 COVID-19 大流行期间尼日利亚生活在艾滋病毒（WGLHIV）的妇女和女孩中无法获得艾滋病毒、结核病和性与生殖健康（SRH）服务的比例以及相关因素。这是一项横断面研究，通过 2021 年 6 月至 10 月在尼日利亚十个州进行的在线调查，招募了具有六个脆弱性类别的 WGLHIV（性工作、交易性性行为、注射或使用非法药物、流动人群、跨性别女性和残疾人士）。使用多变量逻辑回归分析确定了由于 COVID-19 而导致的有限获取 HIV、结核病和 SRH 服务的情况、脆弱性类别以及这些服务的财务和非财务障碍之间的关联。超过 6 成、近 2 成和近 4 成的 WGLHIV 在 COVID-19 大流行期间分别难以获得 HIV、结核病和 SRH 服务。跨性别女性面临有限获取性和生殖健康服务的可能性是其他女性的 3.59 倍（95%CI 2.19-5.91），从事性工作的女性面临有限获取性和生殖健康服务的可能性是其他女性的 4.51 倍（95%CI 2.28-8.42），而注射或使用非法药物的女性面临有限获取性和生殖健康服务的可能性是其他女性的 2.39 倍（95%CI 1.47-32.90）。此外，COVID-19 危机的直接后果，如艾滋病毒服务和 SRH 服务点的关闭，大大加剧了先前存在的障碍。没钱、需要支付额外的非官方费用以及前往卫生机构途中缺乏安全是对获得卫生服务影响最大的障碍。COVID-19 大流行对 WGLHIV 获得基本卫生服务产生了负面影响。边缘化群体受到的影响不成比例地更高。WGLHIV 在大流行期间需要获得无歧视和负担得起的基本卫生服务。
