Department of HIV Services, Populations Solutions for Health, Harare, Zimbabwe.
Department of Health Studies, University of South Africa, Pretoria, South Africa.
Afr J AIDS Res. 2022 Jul;21(2):183-193. doi: 10.2989/16085906.2022.2101934.
This study focuses on female sex workers as a key population group that suffers a degree of vulnerability according to the World Health Organisation (WHO). Key populations refer to people at heightened risk of contracting the human immunodeficiency virus (HIV) due to specific behaviours and social and legal environments which increase their vulnerability to the virus. Key populations are disproportionately affected by HIV, yet they have less access to HIV services compared to the general population. The coronavirus (COVID-19) lockdown and its restrictive measures have further widened the inequalities and gaps in accessing HIV services for this group. A descriptive phenomenological study was undertaken to explore female sex workers' experiences of utilisation of HIV services during COVID-19. The study setting was the Bulawayo Metropolitan Province, Zimbabwe. Data were collected through in-depth individual interviews with 10 female sex workers. Purposive sampling coupled with snowballing was utilised for recruiting participants. Data were analysed guided by the seven-step Colaizzi technique. Rigour was ensured through adhering to Lincoln and Guba's trustworthiness criteria. The study found that the COVID-19 pandemic adversely affected the livelihoods of sex workers and their utilisation of HIV services. There was limited access to HIV services due to an initial lack of travel authorisation letters and financial challenges experienced by study participants. In addition, the quality of care in health care facilities was further compromised by poor screening processes and reduced provider-client interactions. Maintaining access to HIV services for female sex workers during pandemics is critical for the country to attain HIV epidemic control.
本研究关注女性性工作者这一重点人群，根据世界卫生组织（WHO）的定义，他们处于一定程度的弱势地位。重点人群是指由于特定行为以及增加其感染病毒脆弱性的社会和法律环境，而面临更高感染人类免疫缺陷病毒（HIV）风险的人群。重点人群受到 HIV 的不成比例影响，但与一般人群相比，他们获得 HIV 服务的机会更少。冠状病毒（COVID-19）封锁及其限制措施进一步扩大了这一群体获得 HIV 服务的不平等和差距。本研究采用描述性现象学研究方法，探讨了 COVID-19 期间女性性工作者利用 HIV 服务的体验。研究地点是津巴布韦布拉瓦约大都市区。通过与 10 名女性性工作者进行深入的个人访谈收集数据。采用目的抽样和滚雪球抽样相结合的方法招募参与者。数据分析遵循 Colaizzi 七步技术。通过坚持林肯和古巴的可信度标准来确保严谨性。研究发现，COVID-19 大流行对性工作者的生计和他们利用 HIV 服务产生了不利影响。由于最初缺乏旅行授权信和研究参与者面临的财务挑战，获得 HIV 服务的机会有限。此外，由于筛查过程不佳和提供者与客户互动减少，医疗保健设施的护理质量进一步受到影响。在大流行期间为女性性工作者维持获得 HIV 服务对于该国实现 HIV 流行控制至关重要。
