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Lazarus L, McClarty LM, Herpai N, Pavlova D, Tarasova T, Gnatenko A, Bondar T, Lorway R, Becker ML. "…because the social work never ends": a qualitative study exploring how NGOs responded to emerging needs while upholding responsibility to HIV prevention and treatment during the war in Ukraine. J Int AIDS Soc 2024; 27 Suppl 3:e26309. [PMID: 39030857 PMCID: PMC11258434 DOI: 10.1002/jia2.26309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/30/2024] [Indexed: 07/22/2024] Open
Abstract
INTRODUCTION Since the onset of the Russian invasion on 24 February 2022, the health system in Ukraine has been placed under tremendous pressure, with damage to critical infrastructure, large losses of human resources, restricted mobility and significant supply chain interruptions. Based on a longstanding partnership between the Ukrainian Institute for Social Research after Oleksandr Yaremenko (UISR after O. Yaremenko) and the Institute for Global Public Health at the University of Manitoba, we explore the impact of the full-scale war on non-governmental organizations (NGOs, including charitable organizations) providing services for key population groups in Ukraine. METHODS We conducted in-depth qualitative interviews with key representatives from NGOs working with key population groups (i.e., people living with HIV, sex workers, men who have sex with men, people who inject drugs and transgender people) throughout Ukraine. Members of the UISR after O. Yaremenko research team recruited participants from organizations working at national, regional and local levels. The research team members conducted 26 interviews (22 with women and four with men) between 15 May and 7 June 2023. Interviews were conducted virtually in Ukrainian and interpretively analysed to draw out key themes. RESULTS Applying Roels et al.'s notion of "first responders", our findings explore how the full-scale war personally and organizationally impacted workers at Ukrainian NGOs. Despite the impacts to participants' physical and mental health, frontline workers continued to support HIV prevention and treatment while also responding to the need for humanitarian aid among their clients and the wider community. Furthermore, despite inadequate pay and compensation for their work, frontline workers assumed additional responsibilities, thereby exceeding their normal workload during the extraordinary conditions of war. CONCLUSIONS NGOs play a vital role as responders, adapting their services to meet the emergent needs of communities during structural shocks, such as war. There is an urgent need to support NGOs with adequate resources for key population service delivery and to increase support for their important role in humanitarian aid.
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Affiliation(s)
- Lisa Lazarus
- Institute for Global Public HealthRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Department of Community Health SciencesMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
| | - Leigh M McClarty
- Institute for Global Public HealthRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Department of Community Health SciencesMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
| | - Nicole Herpai
- Institute for Global Public HealthRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Department of Community Health SciencesMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
| | - Daria Pavlova
- Institute for Global Public HealthRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Ukrainian Institute for Social Research after Oleksandr YaremenkoKyivUkraine
| | - Tatiana Tarasova
- Ukrainian Institute for Social Research after Oleksandr YaremenkoKyivUkraine
| | - Anna Gnatenko
- Institute for Global Public HealthRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
| | - Tetiana Bondar
- Ukrainian Institute for Social Research after Oleksandr YaremenkoKyivUkraine
| | - Robert Lorway
- Institute for Global Public HealthRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Department of Community Health SciencesMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
| | - Marissa L Becker
- Institute for Global Public HealthRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Department of Community Health SciencesMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
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Lazarus L, Herpai N, Pavlova D, Gill A, Cholette F, McClarty LM, Isac S, Lopatenko A, Pickles M, Mishra S, Shaw SY, Lorway R, McKinnon LR, Sandstrom P, Blanchard J, Balakireva O, Becker ML. A cross-sectional survey exploring HIV and HCV prevalence among men who purchase sex in Dnipro, Ukraine. BMC Public Health 2023; 23:2054. [PMID: 37858070 PMCID: PMC10588219 DOI: 10.1186/s12889-023-16903-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND HIV programming in Ukraine largely targets "key population" groups. Men who purchase sex are not directly reached. The aim of our study was to explore the prevalence of sexually transmitted and blood-borne infections (STBBIs) among men who purchase sex from female sex workers. METHODS Following geographic mapping and population size estimation at each "hotspot", we conducted a cross-sectional bio-behavioural survey with men who purchase sex between September 2017 and March 2018 in Dnipro, Ukraine. Eligibility criteria included purchasing sex services at a "hotspot" and being ≥ 18 years. Participants completed a structured questionnaire, followed by HIV/HCV rapid testing and a dried blood spot (DBS) sample collection for confirmatory serology. RESULTS The study enrolled 370 participants. The median age was 32 (interquartile range [IQR] = 27-38) and the median age of first purchase of sexual services was 22 (IQR = 19-27). Over half (56%) of participants reported ever testing for HIV; four participants (2%, N = 206) reported having tested positive for HIV, with three out of the four reporting being on ART. Forty percent of participants had ever tested for HCV, with three (2%, N = 142) having ever tested positive for HCV. In DBS testing, nine participants (2.4%) tested positive for HIV and 24 (6.5%) tested positive for ever having an HCV infection. CONCLUSION Prevalence of HIV and HCV in this population was high. Given high rates of study enrolment and testing, efforts should be made to reach men who purchase sex with expanded STBBI programming.
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Affiliation(s)
- Lisa Lazarus
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Building, 771 McDermot Ave., Winnipeg, Manitoba, R2E 0T6, Canada.
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Nicole Herpai
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Building, 771 McDermot Ave., Winnipeg, Manitoba, R2E 0T6, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Daria Pavlova
- Ukrainian Institute for Social Research after Oleksandr Yaremenko, Kyiv, Ukraine
| | - Amaanat Gill
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - François Cholette
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Sexually Transmitted and Blood-Borne Infections, National Microbiology Laboratory at JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada
| | - Leigh M McClarty
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Building, 771 McDermot Ave., Winnipeg, Manitoba, R2E 0T6, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Shajy Isac
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Building, 771 McDermot Ave., Winnipeg, Manitoba, R2E 0T6, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
- India Health Action Trust, Delhi, India
| | - Anna Lopatenko
- Dnipropetrovsk Regional Center for Socially Significant Diseases, Dnipro, Ukraine
| | - Michael Pickles
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Sharmistha Mishra
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Souradet Y Shaw
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Building, 771 McDermot Ave., Winnipeg, Manitoba, R2E 0T6, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Robert Lorway
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Building, 771 McDermot Ave., Winnipeg, Manitoba, R2E 0T6, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lyle R McKinnon
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- Department of Medical Microbiology & Immunology, University of Nairobi, Nairobi, Kenya
| | - Paul Sandstrom
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Sexually Transmitted and Blood-Borne Infections, National Microbiology Laboratory at JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada
| | - James Blanchard
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Building, 771 McDermot Ave., Winnipeg, Manitoba, R2E 0T6, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Olga Balakireva
- Ukrainian Institute for Social Research after Oleksandr Yaremenko, Kyiv, Ukraine
- Institute for Economics and Forecasting, Ukrainian National Academy of Sciences, Kyiv, Ukraine
| | - Marissa L Becker
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Building, 771 McDermot Ave., Winnipeg, Manitoba, R2E 0T6, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
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Cholette F, Lazarus L, Macharia P, Thompson LH, Githaiga S, Mathenge J, Walimbwa J, Kuria I, Okoth S, Wambua S, Albert H, Mwangi P, Adhiambo J, Kasiba R, Juma E, Battacharjee P, Kimani J, Sandstrom P, Meyers AFA, Joy JB, Thomann M, McLaren PJ, Shaw S, Mishra S, Becker ML, McKinnon L, Lorway R. Community Insights in Phylogenetic HIV Research: The CIPHR Project Protocol. Glob Public Health 2023; 18:2269435. [PMID: 37851872 DOI: 10.1080/17441692.2023.2269435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023]
Abstract
Inferring HIV transmission networks from HIV sequences is gaining popularity in the field of HIV molecular epidemiology. However, HIV sequences are often analyzed at distance from those affected by HIV epidemics, namely without the involvement of communities most affected by HIV. These remote analyses often mean that knowledge is generated in absence of lived experiences and socio-economic realities that could inform the ethical application of network-derived information in 'real world' programmes. Procedures to engage communities are noticeably absent from the HIV molecular epidemiology literature. Here we present our team's protocol for engaging community activists living in Nairobi, Kenya in a knowledge exchange process - The CIPHR Project (Community Insights in Phylogenetic HIV Research). Drawing upon a community-based participatory approach, our team will (1) explore the possibilities and limitations of HIV molecular epidemiology for key population programmes, (2) pilot a community-based HIV molecular study, and (3) co-develop policy guidelines on conducting ethically safe HIV molecular epidemiology. Critical dialogue with activist communities will offer insight into the potential uses and abuses of using such information to sharpen HIV prevention programmes. The outcome of this process holds importance to the development of policy frameworks that will guide the next generation of the global response.
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Affiliation(s)
- François Cholette
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Sexually Transmitted and Blood-Borne Infections, National Microbiology Laboratory at JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada
| | - Lisa Lazarus
- Institute for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Pascal Macharia
- Health Options for Young Men on HIV/AIDS and STIs (HOYMAS), Nairobi, Kenya
| | - Laura H Thompson
- Sexually Transmitted and Blood-Borne Infections Surveillance Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Canada
| | - Samuel Githaiga
- Health Options for Young Men on HIV/AIDS and STIs (HOYMAS), Nairobi, Kenya
| | - John Mathenge
- Health Options for Young Men on HIV/AIDS and STIs (HOYMAS), Nairobi, Kenya
| | | | - Irene Kuria
- Key Population Consortium of Kenya, Nairobi, Kenya
| | - Silvia Okoth
- Bar Hostess Empowerment and Support Programme, Nairobi, Kenya
| | | | - Harrison Albert
- Health Options for Young Men on HIV/AIDS and STIs (HOYMAS), Nairobi, Kenya
| | - Peninah Mwangi
- Bar Hostess Empowerment and Support Programme, Nairobi, Kenya
| | - Joyce Adhiambo
- Partners for Health Development in Africa (PHDA), Nairobi, Kenya
- Sex Worker Outreach Programme (SWOP), Nairobi, Kenya
| | | | - Esther Juma
- Sex Worker Outreach Programme (SWOP), Nairobi, Kenya
| | | | - Joshua Kimani
- Sex Worker Outreach Programme (SWOP), Nairobi, Kenya
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
| | - Paul Sandstrom
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Sexually Transmitted and Blood-Borne Infections, National Microbiology Laboratory at JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada
| | - Adrienne F A Meyers
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Sexually Transmitted and Blood-Borne Infections, National Microbiology Laboratory at JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada
| | - Jeffrey B Joy
- British Columbia Centre for Excellence in HIV/AIDS (BCCfE), St. Paul's Hospital, Vancouver, Canada
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, Canada
- Bioinformatics Programme, University of British Columbia, Vancouver, Canada
| | - Matthew Thomann
- Department of Anthropology, University of Maryland, College Park, MD, USA
| | - Paul J McLaren
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Sexually Transmitted and Blood-Borne Infections, National Microbiology Laboratory at JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada
| | - Souradet Shaw
- Institute for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Sharmistha Mishra
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Marissa L Becker
- Institute for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lyle McKinnon
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
| | - Robert Lorway
- Institute for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
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Lazarus L, Herpai N, Pavlova D, Murney MA, Balakireva O, Tarasova T, McClarty L, Pickles M, Mishra S, Forget E, Becker M, Lorway R. Exploring the impact of military conflict on sex work in Ukraine: Women's experiences of economic burden. Glob Public Health 2023; 18:2092187. [PMID: 35760779 DOI: 10.1080/17441692.2022.2092187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/30/2022] [Indexed: 11/04/2022]
Abstract
Little is known about the impact of military conflict on sex work from the perspective of sex workers. We attempt to explore the meaning of conflict on sex work by asking women about the changes that they have experienced in their lives and work since the beginning of the 2014 military conflict in eastern Ukraine. The findings in this article are based on qualitative interviews with 43 cisgender women living and practicing sex work in Dnipro, eastern Ukraine. Our analysis highlights the meanings that sex workers have linked to the conflict, with financial concerns emerging as a dominant theme. The conflict therefore functions as a way of understanding changing economic circumstances with both individual and broader impacts. By better understanding the meaning of conflict as expressed by sex workers, we can begin to adapt our response to address emerging, and unmet, needs of the community.
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Affiliation(s)
- Lisa Lazarus
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Nicole Herpai
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Daria Pavlova
- Ukrainian Institute for Social Research after Oleksandr Yaremenko, Kyiv, Ukraine
| | - Maureen A Murney
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
| | - Olga Balakireva
- Ukrainian Institute for Social Research after Oleksandr Yaremenko, Kyiv, Ukraine
- Institute for Economics and Forecasting, Ukrainian National Academy of Sciences, Kyiv, Ukraine
| | - Tatiana Tarasova
- Ukrainian Institute for Social Research after Oleksandr Yaremenko, Kyiv, Ukraine
| | - Leigh McClarty
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Michael Pickles
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Sharmistha Mishra
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Evelyn Forget
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Marissa Becker
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Rob Lorway
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Capasso A, Skipalska H, Chakrabarti U, Guttmacher S, Navario P, Castillo TP. Patterns of Gender-Based Violence in Conflict-Affected Ukraine: A Descriptive Analysis of Internally Displaced and Local Women Receiving Psychosocial Services. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21549-NP21572. [PMID: 34964399 PMCID: PMC9240103 DOI: 10.1177/08862605211063009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Since 2014, a protracted armed conflict has afflicted eastern Ukraine, resulting in the displacement of over 1.4 million residents. The resulting humanitarian crisis has placed women, particularly displaced women, at greater risk of gender-based violence (GBV). In Ukraine, reports of GBV were higher following the start of the conflict (22.4% in 2014 vs. 18.3% in 2007), with displaced women suffering from GBV nearly three times more than non-displaced residents (15.2% vs. 5.3%). Many GBV incidents in Ukraine have been reported along the "contact line," the border separating government from non-government-controlled areas. This study compares types of GBV experienced by displaced and local (non-displaced) women receiving psychosocial support in order to identify the gaps in services during a time of conflict. Data was collected by mental healthcare providers from 11,826 women (25.5% displaced; 74.5% local) aged 15 to 69 receiving psychosocial services in five conflict-affected regions from February 2016 to June 2017. Group differences were assessed using Pearson's chi-squared or Fisher's exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables. Overall, almost half of the women experienced intimate partner violence and psychological abuse. Compared to residents, displaced women were more likely to report non-domestic GBV incidents involving sexual and economic violence. Almost 8% of violent incidents against displaced women occurred at checkpoints or at reception centers for internally displaced persons (IDP) and 20% were perpetrated by armed men. Consistent with the literature, this study suggests that displaced women are more vulnerable to attacks by persons outside the home and by armed groups. Our findings underscore the need to expand violence prevention programs to address the unique vulnerabilities of displaced women before, during, and after displacement. Programs should be tailored to prevent violence within and outside the home. Increased prevention efforts are needed in areas with high concentrations of armed men, along the contact line, and at IDP reception centers to protect displaced women. This is particularly urgent in the context of increased GBV due to COVID-19.
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Affiliation(s)
- Ariadna Capasso
- NYU School of Global Public Health, New York University, New York, NY, USA
| | - Halyna Skipalska
- Ukrainian Foundation for Public Health, Kiev, Ukraine
- HealthRight International, New York, NY, USA
| | | | - Sally Guttmacher
- NYU School of Global Public Health, New York University, New York, NY, USA
- HealthRight International, New York, NY, USA
| | - Peter Navario
- NYU School of Global Public Health, New York University, New York, NY, USA
- HealthRight International, New York, NY, USA
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Murney MA, Lazarus L, Herpai N, Pavlova D, Tarasova T, Balakireva O, Becker ML, Lorway R. Sex work stigma and the recuperation of moral personhood through gendered labour: sex worker diaries in Ukraine. CULTURE, HEALTH & SEXUALITY 2022:1-15. [PMID: 36052988 DOI: 10.1080/13691058.2022.2113433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Based on a diary writing exercise, this paper illuminates the complex ways in which sex workers in Ukraine actively work through and manage stigma in their daily lives. Pushing beyond the notion of stigma as a static and fixed psychosocial designation that can be readily measured, we argue that stigma is actively confronted by sex workers through various forms of gendered emotional and physical labour that enable them to recuperate a sense of moral personhood. This notion of moral personhood is often tied to wider gender-specific values pertaining to caregiving and motherhood.
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Affiliation(s)
- Maureen A Murney
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Lisa Lazarus
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Nicole Herpai
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Daria Pavlova
- Ukrainian Institute for Social Research after Oleksandr Yaremenko, Kyiv, Ukraine
| | - Tatiana Tarasova
- Ukrainian Institute for Social Research after Oleksandr Yaremenko, Kyiv, Ukraine
| | - Olga Balakireva
- Ukrainian Institute for Social Research after Oleksandr Yaremenko, Kyiv, Ukraine
- Institute for Economics and Forecasting, Ukrainian National Academy of Sciences, Kyiv, Ukraine
| | - Marissa L Becker
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Robert Lorway
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Pourkarim MR. World Hepatitis Day in 2022: Challenges of Viral Hepatitis Elimination in Elongated COVID-19 Pandemic. Pathogens 2022; 11:pathogens11091002. [PMID: 36145433 PMCID: PMC9504199 DOI: 10.3390/pathogens11091002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mahmoud Reza Pourkarim
- Laboratory for Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium;
- Health Policy Research Centre, Institute of Health, Shiraz University of Medical Sciences, Shiraz P.O. Box 71348-14336, Iran
- Blood Transfusion Research Centre, High Institute for Research and Education in Transfusion Medicine, Tehran 14665-1157, Iran
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Derksen J, Pavlova D, McClarty LM, Balakireva O, Herpai N, Lazarus L, Tennakoon A, Tarasova T, Lorway R, Pickles M, Mishra S, Shaw SY, Becker ML. Awareness and Utilization of HIV Testing and Prevention Services Among Female Sex Workers in Dnipro, Ukraine: Implications for Prevention Program Strengthening From the Dynamics Study. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:879191. [PMID: 36303675 PMCID: PMC9580627 DOI: 10.3389/frph.2022.879191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/10/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Approximately 240,000 people live with HIV in Ukraine, concentrated among key populations, including sex workers. Non-governmental organizations (NGOs) play an important role in the funding and delivery of HIV testing and prevention services in Ukraine. These services are set within the context of national healthcare reforms as well as ongoing armed conflict. This study seeks to describe and understand the usage of HIV testing and prevention services among sex workers in the eastern Ukrainian city of Dnipro. Methods A cross-sectional bio-behavioral survey was administered in September 2017-March 2018 among 560 sex workers working in Dnipro. Descriptive analyses of survey data are presented alongside multivariable logistic regression models identifying factors associated with NGO awareness and HIV testing in the past 12 months; adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) are reported. Results Sixty-two percent of respondents were aware of NGOs offering HIV services. Sixty-eight percent had tested for HIV in the past 12 months, and 51% of those who reported the location of their most recent test were tested at an NGO. Those with 5–9 years in sex work had greater odds of being aware of NGOs (AOR = 5.5, 95%CI: 3.2–9.7) and testing for HIV (AOR = 3.4, 95%CI: 2.0–6.0) compared to those new to the profession. Contact with outreach workers was strongly associated with increased odds of testing (AOR = 13.0, 95%CI: 7.0–24.0). Sex workers in “offices” (brothel-like venues) reported higher odds of testing than all other workplaces, while those in entertainment venues (AOR = 0.3, 95%CI: 0.2–0.5) and public places (AOR = 0.2, 95%CI: 0.1–0.3) reported lower rates. Receiving prevention services, such as free condoms, was associated with increased testing (AOR = 16.9, 95%CI: 9.7–29.3). Discussion NGOs in Dnipro, Ukraine play an important role in HIV testing and prevention for women involved in sex work. However, focused efforts should be placed on supporting access to these services for women that are newer to sex work, and those working in entertainment venues or public places. Outreach workers appear to support access to HIV prevention information and supplies and facilitate linkages to HIV testing for sex workers.
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Affiliation(s)
- Joel Derksen
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Daria Pavlova
- Ukrainian Institute for Social Research After Olexander Yaremenko, Kyiv, Ukraine
| | - Leigh M. McClarty
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Olga Balakireva
- Ukrainian Institute for Social Research After Olexander Yaremenko, Kyiv, Ukraine
- Institute for Economics and Forecasting, Ukrainian National Academy of Sciences, Kyiv, Ukraine
| | - Nicole Herpai
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa Lazarus
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Aruni Tennakoon
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Tatiana Tarasova
- Ukrainian Institute for Social Research After Olexander Yaremenko, Kyiv, Ukraine
| | - Robert Lorway
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Michael Pickles
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Sharmistha Mishra
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Souradet Y. Shaw
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Marissa L. Becker
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- *Correspondence: Marissa L. Becker
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Vasylyev M, Skrzat-Klapaczyńska A, Bernardino JI, Săndulescu O, Gilles C, Libois A, Curran A, Spinner CD, Rowley D, Bickel M, Aichelburg MC, Nozza S, Wensing A, Barber TJ, Waters L, Jordans C, Bramer W, Lakatos B, Tovba L, Koval T, Kyrychenko T, Dumchev K, Buhiichyk V, Smyrnov P, Antoniak S, Antoniak S, Vasylyeva TI, Mazhnaya A, Kowalska J, Bhagani S, Rokx C. Unified European support framework to sustain the HIV cascade of care for people living with HIV including in displaced populations of war-struck Ukraine. THE LANCET HIV 2022; 9:e438-e448. [DOI: 10.1016/s2352-3018(22)00125-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/24/2022]
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10
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Herpai N, Lazarus L, Forget E, Balakireva O, Pavlova D, McClarty L, Lorway R, Pickles M, Isac S, Sandstrom P, Aral S, Mishra S, Ma H, Blanchard J, Becker M, On Behalf Of The Dynamics Study Team. Exploring the dynamics of workplace typologies for sex workers in Eastern Ukraine. Glob Public Health 2021; 17:2034-2053. [PMID: 34403303 DOI: 10.1080/17441692.2021.1965180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We examine the typologies of workplaces for sex workers in Dnipro, Ukraine as part of the larger Dynamics Study, which explores the influence of conflict on sex work. We conducted a cross-sectional survey with 560 women from September 2017 to October 2018. The results of our study demonstrate a diverse sex work environment with heterogeneity across workplace typologies in terms of remuneration, workload, and safety. Women working in higher prestige typologies earned a higher hourly wage, however client volume also varied which resulted in comparable monthly earnings from sex work across almost all workplace types. While sex workers in Dnipro earn a higher monthly wage than the city mean, they also report experiencing high rates of violence and a lack of personal safety at work. Sex workers in all workplaces, with the exception of those working in art clubs, experienced physical and sexual violence perpetrated by law enforcement officers and sex partners. By understanding more about sex work workplaces, programmes may be better tailored to meet the needs of sex workers and respond to changing work environments due to ongoing conflict and COVID-19 pandemic.
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Affiliation(s)
- Nicole Herpai
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lisa Lazarus
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Evelyn Forget
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Olga Balakireva
- Institute for Economics and Forecasting, Ukrainian National Academy of Sciences, Kyiv, Ukraine.,Ukrainian Institute for Social Research after Olexander Yaremenko, Kyiv, Ukraine
| | - Daria Pavlova
- Ukrainian Institute for Social Research after Olexander Yaremenko, Kyiv, Ukraine
| | - Leigh McClarty
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Robert Lorway
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Michael Pickles
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | | | - Paul Sandstrom
- National HIV and Retrovirology Laboratories, Public Health Agency of Canada, Winnipeg, Canada
| | - Sevgi Aral
- Division of Sexually Transmitted Disease Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sharmistha Mishra
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Huiting Ma
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - James Blanchard
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Marissa Becker
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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