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Characterising the relationship between migration and stigma affecting healthcare engagement among female sex workers in Lomé, Togo
- Source :
- Glob Public Health
- Publication Year :
- 2019
- Publisher :
- Informa UK Limited, 2019.
-
Abstract
- Migration in West Africa is common and complicates the sustained delivery of comprehensive HIV care programmes for those with specific vulnerabilities to HIV, including female sex workers (FSW). This study evaluated whether migration potentiates the burden of stigma affecting FSW in Lomé, Togo. Respondent driven sampling identified 354 FSW who completed HIV testing and a questionnaire. Multivariable logistic regression was used to identify factors associated with stigma among FSW. Among study participants, 76.3% (270/354) were migrants, with 30.2% (107/354) reporting stigma. Migrant FSW were less likely to report stigma (aOR 0.40; 95% CI:0.22-0.73). FSW who had an abortion (aOR 3.40; 95% CI:1.79-6.30) and were tested for a sexually transmitted infection (STI) or HIV (aOR 2.03; 95% CI:1.16-3.55) were more likely to report stigma. Among FSW, 59.8% (211/353) disclosed selling sex to a health worker. Disclosure was more common among FSW who had been tested for an STI or HIV (36.7%; 77/210), or both (55.7%; 117/210), and resulted in an attenuated but significant association between STI or HIV testing and stigma, indicating that disclosure partially mediated the relationship. These results highlight the need to mitigate healthcare-related stigma affecting FSW, while also considering decentralised HIV testing approaches, including HIV self-testing.
- Subjects :
- Adult
Adolescent
Social Stigma
Sexually Transmitted Diseases
Human immunodeficiency virus (HIV)
Stigma (botany)
Abortion
urologic and male genital diseases
Logistic regression
medicine.disease_cause
Article
West africa
Young Adult
03 medical and health sciences
0302 clinical medicine
Surveys and Questionnaires
Environmental health
Health care
Humans
Medicine
030212 general & internal medicine
Transients and Migrants
Sex Workers
030505 public health
business.industry
Public Health, Environmental and Occupational Health
virus diseases
Female sex
social sciences
Patient Acceptance of Health Care
female genital diseases and pregnancy complications
Logistic Models
Togo
Respondent
population characteristics
Female
0305 other medical science
business
Subjects
Details
- ISSN :
- 17441706 and 17441692
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Global Public Health
- Accession number :
- edsair.doi.dedup.....7fde74721c3cf6ed47150fe7fe04b9f4