埃塞俄比亚亚的斯亚贝巴的女性性工作者中，临时服务中心对艾滋病毒检测、病例发现和 condom 使用的影响。

The effect of drop-in centers on access to HIV testing, case finding, and condom use among female sex workers in Addis Ababa, Ethiopia.

机构信息

HIV and TB Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.

Department of Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.

出版信息

PeerJ. 2023 Oct 17;11:e16144. doi: 10.7717/peerj.16144. eCollection 2023.

DOI:10.7717/peerj.16144

PMID:37868058

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10588723/

Abstract

BACKGROUND

Varied HIV prevention interventions involving multiple strategies has been instrumental in the effort to contain and lessen the prevalence of HIV around the globe. However, female sex workers (FSWs) often face stigma and discriminatory challenges, resulting in lower access to the HIV prevention initiatives. This study has aimed to assess the effect of one of the HIV service delivery models, the Drop-in Centers (DICs), which is designed to overcome the service uptake barriers of FSWs.

METHOD

A quasi-experimental study design was employed. A respondent-driven sampling technique was used to recruit 1,366 FSWs from January to June 2020. A propensity score matching technique was used to balance the potential confounders between FSWs who had access to DICs and those who had never accessed DICs. Comparisons of the effect of DIC on the outcome of interest was made using a logit regression model at a 5% level of significance.

RESULTS

A total of 1,366 FSWs took part in the study. The analysis estimated the average treatment effects of access to DICs on four key outcomes: ever-testing to know HIV status, finding HIV-positive FSWs, awareness of HIV-positive status, and consistent condom use. A significant effect of DIC was seen at a 95% confidence interval on each outcome. Access to DIC produced a 7.58% increase in the probability of testing to know HIV status ( < 0.001), a 7.02% increment in finding HIV-positive FSWs ( = 0.003), an increase of 6.93% in awareness of HIV status among HIV positive FSWs ( = 0.001), and a 4.39% rise in consistent condom use ( = 0.01).

CONCLUSIONS

Ensuring access of FSWs to DICs has led to an upsurge in HIV testing among FSWs, raising HIV status awareness among those who are HIV positive, and encouraged consistent condom use. To provide effective HIV prevention services, particularly to those FSWs living with HIV, it is essential to strengthen the services provided in DICs and expand the centers. This will ensure that the entire network of FSWs is reached with appropriate HIV prevention services.

摘要

背景

多种涉及多种策略的艾滋病毒预防干预措施在遏制和降低全球艾滋病毒流行方面发挥了重要作用。然而，性工作者（FSWs）经常面临污名化和歧视性挑战，导致她们获得艾滋病毒预防措施的机会减少。本研究旨在评估艾滋病毒服务提供模式之一——“Drop-in Centers（DICs）”的效果，该模式旨在克服 FSWs 获得服务的障碍。

方法

采用准实验研究设计。采用 respondent-driven sampling 技术，于 2020 年 1 月至 6 月招募了 1366 名性工作者。采用倾向评分匹配技术，在接受 DIC 和从未接受 DIC 的 FSW 之间平衡潜在混杂因素。使用对数回归模型，在 5%的显著性水平上比较 DIC 对感兴趣结果的影响。

结果

共有 1366 名性工作者参加了这项研究。分析估计了获得 DIC 对四个关键结果的平均处理效果：曾经接受过 HIV 检测以了解 HIV 状况、发现 HIV 阳性的性工作者、知晓 HIV 阳性状况和坚持使用避孕套。在每个结果上，DIC 的作用都在 95%置信区间内具有统计学意义。获得 DIC 使检测 HIV 状况的概率增加了 7.58%（<0.001），发现 HIV 阳性性工作者的概率增加了 7.02%（=0.003），HIV 阳性性工作者知晓 HIV 状况的比例增加了 6.93%（=0.001），坚持使用避孕套的比例增加了 4.39%（=0.01）。

结论

确保性工作者获得 DIC 服务，提高了性工作者的 HIV 检测率，提高了 HIV 阳性者的 HIV 状况意识，并鼓励其坚持使用避孕套。为了提供有效的艾滋病毒预防服务，特别是为那些感染艾滋病毒的性工作者，必须加强 DIC 提供的服务，并扩大中心的规模。这将确保整个性工作者网络都能获得适当的艾滋病毒预防服务。