Lotysh Anastasiia, Tezcan-Güntekin Hürrem, Kalinowski Olivia, Kaya Gizem, Kroehn-Liedtke Franziska, Mihaylova Hristiana, Schouler-Ocak Meryam, Rössler Wulf
Psychiatric University Clinic of Charité at St. Hedwig Hospital, Department of Psychiatry and Neurosciences, Berlin, Germany.
Berlin School of Public Health, Berlin, Germany.
Front Public Health. 2025 Jan 14;12:1464307. doi: 10.3389/fpubh.2024.1464307. eCollection 2024.
Migrant female sex workers (MFSWs) can be exposed to various health risks due to their occupation, including mental and physical health, substance use, and experience of violence. However, they face substantial barriers to accessing healthcare services. The inadequate access to medical care for migrant female sex workers poses a challenge to the German healthcare system.
This qualitative study aimed to identify and analyze the barriers to the use of health and mental health services by migrant female sex workers in Berlin and what should be done to improve the access to healthcare and to make it easier to use health and mental health services for migrant female sex workers. The data collected can be used to derive overarching recommendations and strategies for action.
Semi-structured, guided interviews were conducted with 10 migrant female sex workers in Berlin, Germany. The interviews were audio recorded, and the content of the transcribed interviews was analyzed. A structuring qualitative content analysis, according to Kuckartz, with deductive-inductive category formation was conducted in MAXQDA 2022.
Barriers were analyzed at three levels: patient, provider, and system. The patient level was related to the patient characteristics: social structure variables, health beliefs and attitudes, personal enabling resources, community enabling resources, perceived illness, and personal health practices. The provider level was related to the provider characteristics: skills and attitudes. The system level was related to the system characteristics: the organization of the healthcare system on local and national levels. Moreover, needs for actions were identified, which can be used for deriving recommendations for the improvement of healthcare situation of migrant sex workers living in Berlin.
CONCLUSION/DISCUSSION: Health services and future intervention studies should consider barriers identified in this study to improve the health services utilization and health of sex workers as part of the effort to protect the right of humans to health.
移民女性性工作者因其职业可能面临各种健康风险，包括身心健康、药物使用和暴力经历。然而，她们在获得医疗服务方面面临重大障碍。移民女性性工作者难以获得医疗护理给德国医疗系统带来了挑战。
这项定性研究旨在识别和分析柏林的移民女性性工作者在使用健康和心理健康服务方面的障碍，以及应采取哪些措施来改善医疗服务的可及性，使移民女性性工作者更易于使用健康和心理健康服务。收集到的数据可用于得出总体建议和行动策略。
对德国柏林的10名移民女性性工作者进行了半结构化的引导式访谈。访谈进行了录音，并对转录访谈的内容进行了分析。在MAXQDA 2022中，根据库卡茨的方法，采用演绎 - 归纳类别形成法进行了结构化定性内容分析。
在三个层面分析了障碍：患者层面、提供者层面和系统层面。患者层面与患者特征相关：社会结构变量、健康信念和态度、个人支持资源、社区支持资源、感知疾病和个人健康行为。提供者层面与提供者特征相关：技能和态度。系统层面与系统特征相关：地方和国家层面的医疗系统组织。此外，还确定了行动需求，可用于为改善居住在柏林的移民性工作者的医疗状况得出建议。
结论/讨论：卫生服务和未来的干预研究应考虑本研究中确定的障碍，以提高性工作者的卫生服务利用率和健康水平，作为保护人类健康权努力的一部分。
