TY - JOUR
T1 - Characterising the relationship between migration and stigma affecting healthcare engagement among female sex workers in Lomé, Togo
AU - Lasater, Molly E.
AU - Grosso, Ashley
AU - Ketende, Sosthenes
AU - Lyons, Carrie
AU - Pitche, Vincent Palokinam
AU - Tchalla, Jules
AU - Anato, Simplice
AU - Sodji, Dométo
AU - Nadedjo, Felicity
AU - Baral, Stefan
N1 - Funding Information:
This work was supported by the USAID and Project SEARCH, Task Order No. 2, was funded by the US Agency for International Development under Contract No. GHH-I-00-0700,032-00, beginning September 30, 2008, and supported by the President’s Emergency Plan for AIDS Relief. The Research to Prevention (R2P) Project was led by the Johns Hopkins Center for Global Health and managed by the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP). The funding body had no role in the design of the study or collection, analysis, and interpretation of data or in writing the manuscript. Molly Lasater was supported by National Institute of Mental Health National Research Service Award (GRANT 12054488; Award ID 1F31 MH110155-01A1).
Funding Information:
This work was supported by the USAID and Project SEARCH, Task Order No. 2, was funded by the US Agency for International Development under Contract No. GHH-I-00-0700,032-00, beginning September 30, 2008, and supported by the President?s Emergency Plan for AIDS Relief. The Research to Prevention (R2P) Project was led by the Johns Hopkins Center for Global Health and managed by the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP). The funding body had no role in the design of the study or collection, analysis, and interpretation of data or in writing the manuscript. Molly Lasater was supported by National Institute of Mental Health National Research Service Award (GRANT 12054488; Award ID 1F31 MH110155- 01A1). The authors are grateful to the women who participated in this study, the Togo Ministry of Health for approving and collaborating on the study, Erin Papworth and Ping-An (Annie) Chen for their support in implementing the study, and the team at USAID and USAID West Africa for their important role in the success of this study.
Publisher Copyright:
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - HIV
KW - Stigma
KW - female sex workers
KW - healthcare engagement
KW - migration
UR - http://www.scopus.com/inward/record.url?scp=85065302532&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065302532&partnerID=8YFLogxK
U2 - 10.1080/17441692.2019.1611896
DO - 10.1080/17441692.2019.1611896
M3 - Article
C2 - 31057037
AN - SCOPUS:85065302532
SN - 1744-1692
VL - 14
SP - 1428
EP - 1441
JO - Global Public Health
JF - Global Public Health
IS - 10
ER -