Brown School, Washington University in St. Louis, St. Louis, MO, United States of America.
International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO, United States of America.
PLoS One. 2023 Jan 12;18(1):e0280138. doi: 10.1371/journal.pone.0280138. eCollection 2023.
The HIV burden remains a critical public health concern and women engaged in sex work [WESW] are at significantly higher risk compared to the general adult population. Similar to other sub-Saharan African countries, Uganda reports high rates of HIV prevalence among WESW. Yet, they have not been targeted by theory-informed HIV prevention intervention approaches.
We conducted semi-structured in-depth interviews with 20 WESW upon intervention completion to explore their experiences with an evidence-based HIV risk reduction intervention that was implemented as part of a combination intervention tested in a clinical trial in Uganda (2018-2023. Specifically, we explored their initial motivations and concerns for participating in the intervention, barriers and facilitators to attendance, and their feedback on specific intervention characteristics.
The main expectations revolved around access to health-related information, including information on STIs, HIV, and PrEP as well as on how one can protect themselves while engaging in sex work. Initial concerns were around potential breach of confidentiality and fear of arrest. The main facilitators for session attendance were the motivation to learn health-related information, the attitude of facilitators, and the incentives received for participation, whereas main challenges were related to family commitments and work schedules. WESW appreciated the group format of the intervention and found the location and times of the intervention delivery acceptable.
Overall, our findings suggest that the HIV risk reduction intervention was appropriate and acceptable to WESW. Yet, WESW experience unique concerns and barriers that need to be accounted for when designing interventions targeting this population, especially in resource-limited settings where sex work is illegal and highly stigmatized.
NCT03583541.
艾滋病毒负担仍然是一个重大的公共卫生关注点，与普通成年人群相比，从事性工作的女性（WESW）面临着更高的风险。与其他撒哈拉以南非洲国家一样，乌干达报告称，WESW 中的艾滋病毒感染率很高。然而，针对她们的理论指导的艾滋病毒预防干预措施并未得到实施。
我们在干预措施完成后对 20 名 WESW 进行了半结构式深入访谈，以探讨她们对基于证据的艾滋病毒减少风险干预措施的经验，该干预措施是在乌干达进行的一项组合干预措施（2018-2023 年）的一部分。具体来说，我们探讨了她们最初参与干预的动机和担忧、参加的障碍和促进因素，以及对特定干预特征的反馈。
主要期望围绕着获取与健康相关的信息，包括性传播感染、艾滋病毒和 PrEP 的信息，以及如何在从事性工作时保护自己。最初的担忧是潜在的保密性违反和被捕的恐惧。出席会议的主要促进因素是学习健康相关信息的动机、促进者的态度以及参与获得的奖励，而主要挑战与家庭承诺和工作时间表有关。WESW 欣赏干预措施的小组形式，并认为干预措施的地点和时间可以接受。
总的来说，我们的研究结果表明，艾滋病毒减少风险干预措施对 WESW 是适当和可接受的。然而，WESW 经历了独特的担忧和障碍，在设计针对这一人群的干预措施时需要考虑到这些因素，特别是在性工作非法且高度污名化的资源有限的环境中。
NCT03583541。
