Department of Public Health, Mental Health, and Maternal and Child Health Nursing. Doctoral Program in Nursing and Health, University of Barcelona, Barcelona, Spain.
Department of Public Health, Mental Health, and Maternal and Child Health Nursing. ADHUC. Research Center for Theory, Gender, Sexuality. University of Barcelona, Barcelona, Spain.
PLoS One. 2024 Jun 12;19(6):e0305293. doi: 10.1371/journal.pone.0305293. eCollection 2024.
The stigma and social discrimination against cisgender women sex workers lead many of them to live in conditions characterized by social inequality, marginalization, persecution, and limited opportunities for sexual health literacy. Consequently, they are often compelled to establish a framework of preventive beliefs with little scientific validity, which they use to identify, mitigate, or avoid sexual health risks arising from their interactions with clients. This study investigates the sexual health beliefs that influence self-care practices aimed at preventing sexually transmitted infections among cisgender women sex workers in Colombia.
We conducted a qualitative study framed in Hermeneutic Phenomenology. In-depth interviews and discussion groups were conducted with 34 cisgender women sex workers over 18 years of age in the center of the cities of Bogotá and Barranquilla in Colombia.
Seven themes emerged from the reflective and inductive thematic analysis of the narratives: (1) popular habits for the prevention of contagion, (2) ocular assessment of genitals, (3) condom lubrication, (4) suspicion of a hidden infection in the client, (5) saliva and oral contact as a source of contagion, (6) avoidance of semen contact, (7) and trust in God as protection.
The findings reflect the need for health and social professionals to promote participatory and inclusive cooperation with sex workers to update the framework of preventive beliefs that help them guide sexual health self-care with autonomy and self-efficacy, strengthening favorable beliefs and negotiating unfavorable ones. It is also essential to have a sex worker-informed sexual health policy that guides the promotion of sexual health that is sensitive to the needs and consistent with the risks of sex work and ensures friendly and non-oppressive preventive care environments for sex workers.
顺性别女性性工作者面临着耻辱和社会歧视,这使她们生活在社会不平等、边缘化、迫害和性健康知识获取机会有限的环境中。因此,她们常常被迫建立一个缺乏科学有效性的预防信念框架,用这些信念来识别、减轻或避免与客户互动时产生的性健康风险。本研究旨在调查影响哥伦比亚顺性别女性性工作者自我保健行为以预防性传播感染的性健康信念。
我们进行了一项定性研究,框架是解释现象学。在哥伦比亚的波哥大和巴兰基亚市中心,我们对 34 名 18 岁以上的顺性别女性性工作者进行了深入访谈和小组讨论。
通过对叙述内容的反思性和归纳性主题分析,出现了七个主题:(1)预防传染的流行习惯,(2)生殖器的眼部评估,(3)避孕套的润滑,(4)对客户潜在感染的怀疑,(5)唾液和口腔接触作为传染源,(6)避免精液接触,(7)相信上帝是保护。
研究结果反映了卫生和社会专业人员需要与性工作者进行参与式和包容性合作,更新预防信念框架,帮助她们自主和自信地指导性健康自我保健,强化有利的信念并协商不利的信念。制定以性工作者为导向的性健康政策也很重要,该政策指导促进性健康,要敏感地了解性工作的需求和风险,并确保为性工作者提供友好和非压迫性的预防性保健环境。