Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA.
Division of Prevention and Community Research, Department of Psychiatry, School of Medicine, Yale University, New Haven, CT 06520, USA.
Int J Environ Res Public Health. 2024 Jan 31;21(2):163. doi: 10.3390/ijerph21020163.
HIV incidence remains alarmingly high among female sex workers (FSWs) in Uganda, necessitating targeted interventions. This study aimed to identify individual and provider-level barriers and facilitators to primary HIV prevention among FSWs in an urban setting. Focus groups involving FSWs and healthcare providers (HCPs) were conducted to inform the development of tailored prevention interventions. Results revealed that all participants had mobile phones, recent sexual activity, and a history of HIV testing, with high rates of sexually transmitted infections and varying HIV test results. FSWs displayed a well-informed awareness of HIV transmission risks, emphasizing the threat for those not testing positive. They unanimously recognized the crucial role of HIV testing in informing, mitigating risks, promoting ART use, and endorsing consistent condom usage. Despite heightened awareness, HCPs noted potential underestimation of vulnerability. Various challenges, including inadequate condom usage, substance abuse, and client dynamics, underscored the complexity of safeguarding against HIV transmission among FSWs. Widespread alcohol and drug use, including marijuana, kuber, and khat, served as coping mechanisms and social facilitators. Some FSWs successfully reduced alcohol intake, highlighting challenges in addressing substance use. FSWs preferred group discussions in health education programs, emphasizing peer interactions and the effectiveness of visual aids in HIV prevention education. This study provides comprehensive insights to guide the development of targeted interventions addressing the multi-faceted challenges FSWs face in HIV prevention.
在乌干达，性工作者（FSW）中艾滋病毒感染率仍然高得令人震惊，需要采取有针对性的干预措施。本研究旨在确定城市环境中 FSW 进行初级艾滋病毒预防的个人和提供者层面的障碍和促进因素。进行了涉及 FSW 和医疗保健提供者（HCP）的焦点小组，以为量身定制的预防干预措施的制定提供信息。结果表明，所有参与者都有手机，最近有过性行为，并且有过艾滋病毒检测史，性传播感染率很高，艾滋病毒检测结果各不相同。FSW 对艾滋病毒传播风险有很好的了解，强调了那些未检测出阳性的人的威胁。他们一致认为艾滋病毒检测在告知、降低风险、促进抗逆转录病毒治疗的使用以及支持持续使用避孕套方面至关重要。尽管认识有所提高，但 HCP 指出，潜在的脆弱性可能被低估了。各种挑战，包括避孕套使用不足、药物滥用和客户动态，强调了在 FSW 中预防艾滋病毒传播的复杂性。广泛的酒精和毒品使用，包括大麻、库伯和阿拉伯茶，是应对机制和社交促进因素。一些 FSW 成功减少了酒精摄入量，突出了解决药物使用问题的挑战。FSW 更喜欢在健康教育计划中进行小组讨论，强调同伴互动和视觉辅助在艾滋病毒预防教育中的有效性。本研究提供了全面的见解，以指导制定针对 FSW 在艾滋病毒预防方面面临的多方面挑战的有针对性的干预措施。
