Implementing Evidence-Based HIV Prevention for Female Sex Workers in Mexico: Provider Assessments of Feasibility and Acceptability

"I decided in my heart I have to complete the sessions": A qualitative study on the acceptability of an evidence-based HIV risk reduction intervention among women engaged in sex work in Uganda

BACKGROUND

The HIV burden remains a critical public health concern and women engaged in sex work [WESW] are at significantly higher risk compared to the general adult population. Similar to other sub-Saharan African countries, Uganda reports high rates of HIV prevalence among WESW. Yet, they have not been targeted by theory-informed HIV prevention intervention approaches.

METHODS

We conducted semi-structured in-depth interviews with 20 WESW upon intervention completion to explore their experiences with an evidence-based HIV risk reduction intervention that was implemented as part of a combination intervention tested in a clinical trial in Uganda (2018-2023. Specifically, we explored their initial motivations and concerns for participating in the intervention, barriers and facilitators to attendance, and their feedback on specific intervention characteristics.

RESULTS

The main expectations revolved around access to health-related information, including information on STIs, HIV, and PrEP as well as on how one can protect themselves while engaging in sex work. Initial concerns were around potential breach of confidentiality and fear of arrest. The main facilitators for session attendance were the motivation to learn health-related information, the attitude of facilitators, and the incentives received for participation, whereas main challenges were related to family commitments and work schedules. WESW appreciated the group format of the intervention and found the location and times of the intervention delivery acceptable.

DISCUSSION AND CONCLUSIONS

Overall, our findings suggest that the HIV risk reduction intervention was appropriate and acceptable to WESW. Yet, WESW experience unique concerns and barriers that need to be accounted for when designing interventions targeting this population, especially in resource-limited settings where sex work is illegal and highly stigmatized.

CLINICAL TRIAL REGISTRATION

NCT03583541.

Exploring the reasons for women to engage in sex work in Tehran, Iran: A qualitative study

Background

Sex work is a growing phenomenon triggered by a number of causes. The current study uses a qualitative method to investigate the reasons why women participate in sex work in Tehran.

Methods

The statistical population consisted of all female sex workers in Tehran, Iran, from which 22 individuals were chosen via snowball sampling. In-depth interviews were conducted for data gathering, and traditional content analysis was used for data analysis. Graneheim and Lundman's method was utilized to evaluate the data, and Guba and Lincoln's criteria were employed to determine the research's strength and transferability.

Results

The results of the data analysis were divided into five categories (or themes) and 19 subcategories. The categories were familial instability, societal pressure, consumerism, social insecurity, and a meek and inefficient personality.

Conclusion

Sex work may be avoided by raising women's social status, providing greater economic assistance, making society safer, particularly in workplaces, improving intra-family connections, boosting self-esteem and self-efficacy, and teaching them how to deal with life's issues.

Experiences and challenges of Prostitute Women in Iran: A phenomenological qualitative study

Background

Prostitutes in Iran are faced with many challenges and problems that pose risks to their health.

Objective

The present study is an attempt to identify and narrate the challenges and experiences of Iranian prostitutes based on a qualitative approach.

Methods

This qualitative study was conducted with a phenomenological approach in (2018) in Tehran, Iran. The data were collected through semi-structured interviews with 22 prostitutes who were selected using a snowball sampling method and analyzed with Colaizzi's method. In order to examine the quality of findings, Guba and Lincoln's measures were used.

Results

Data analysis results were classified into five main categories and 14 subcategories. The main issues are: The experience of violence, Heath risk, social ostracism, objectifying, and lack of social and legal supporting structures.

Conclusion

Prostitutes in Iran experience numerous problems at personal and social levels. By providing social, economic, and legal supports for them such as social services (e.g. educations on how to use contraceptives, how to have safe sexual intercourse, and free counseling services for mental support), we can improve their health and welfare.