Madimutsa Gracious, Machingura Fortunate, Nyamwanza Owen, Cowan Frances M, Mavhu Webster
Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), Harare, Zimbabwe.
Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
PLOS Glob Public Health. 2025 Apr 24;5(4):e0003883. doi: 10.1371/journal.pgph.0003883. eCollection 2025.
Self-help groups (SHGs) have been effective in improving the health and wellbeing of women generally but there is little evidence on whether and how they improve HIV and sexual and reproductive health (SRH) outcomes among female sex workers (FSWs), particularly in sub-Saharan Africa. This scoping review attempted to address this gap by identifying and analysing literature on SHGs for FSWs in sub-Saharan Africa. The review followed the 5-step framework developed by Arksey and O'Malley: 1) defining the research question, 2) identifying relevant studies, 3) selecting studies, 4) charting the data, and 5) collating, summarising, and reporting the results. We searched three databases (CINAHL, Medline and Global Health) for peer-reviewed articles published between 1 January 2000 and 30 September 2024. We identified eleven studies: two were quantitative, seven were qualitative and two were mixed methods. Studies were from seven countries in sub-Saharan Africa. The studies suggested that SHGs can improve SRH outcomes and reduce HIV vulnerabilities among FSWs by providing emotional and financial support, health education, linkage to care and social capital (i.e., benefits derived from association). The studies also highlighted the need for tailored interventions that address the unique needs and challenges faced by FSWs. This scoping review highlights the crucial contribution that SHGs make in promoting social cohesion, SRH and HIV outcomes among FSWs across seven countries in sub-Saharan Africa. To build resilience and facilitate better health outcomes, FSWs need to be empowered at individual, societal and resource levels through SHGs. Further research on the formation, structure, leadership, sustainability of SHGs and contextual factors, is required for understanding the best practices of their implementation to achieve long-term success.
自助小组通常在改善女性的健康和福祉方面很有效,但几乎没有证据表明它们是否以及如何改善女性性工作者的艾滋病毒及性与生殖健康(SRH)结果,尤其是在撒哈拉以南非洲地区。这项范围综述试图通过识别和分析撒哈拉以南非洲地区女性性工作者自助小组的文献来填补这一空白。该综述遵循了阿克西和奥马利制定的五步框架:1)界定研究问题,2)识别相关研究,3)选择研究,4)梳理数据,5)整理、总结和报告结果。我们在三个数据库(CINAHL、Medline和全球健康)中搜索了2000年1月1日至2024年9月30日期间发表的同行评议文章。我们识别出了11项研究:两项是定量研究,七项是定性研究,两项是混合方法研究。这些研究来自撒哈拉以南非洲的七个国家。研究表明,自助小组可以通过提供情感和经济支持、健康教育、护理联系和社会资本(即从社团中获得的益处)来改善女性性工作者的性与生殖健康结果,并降低其感染艾滋病毒的易感性。研究还强调了需要有针对性的干预措施来解决女性性工作者面临的独特需求和挑战。这项范围综述突出了自助小组在促进撒哈拉以南非洲七个国家女性性工作者的社会凝聚力、性与生殖健康及艾滋病毒相关结果方面所做出的关键贡献。为了增强复原力并促进更好的健康结果,需要通过自助小组在个人、社会和资源层面增强女性性工作者的权能。需要对自助小组的形成、结构、领导力、可持续性以及背景因素进行进一步研究,以了解其实施的最佳做法,从而实现长期成功。
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