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1.
AIDS Behav ; 28(7): 2350-2360, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38605251

RESUMO

Women employed by sex work (WESW) experience significant gaps in accessing necessary healthcare services, leading to unmet health needs. Yet, there is a dearth of literature on the barriers to medical care access among WESW in Uganda. We used data from the Kyaterekera baseline to examine the correlates of access to medical care among WESW, defined as the ability of individuals to obtain the necessary healthcare services they require in a timely, affordable, and equitable manner. The Kyaterekera study recruited 542 WESW aged 18-58 years from Southern Uganda. We conducted a multilevel linear regression model to determine the intrapersonal (age, education level, marital status, HIV knowledge, and asset ownership), interpersonal (family cohesion and domestic violence attitudes), and community (community satisfaction, sex work stigma and distance to health facility) level correlates of access to medical care among WESW. Intrapersonal and interpersonal factors were associated with access to medical care among WESW. There was no significant association between community level factors and access to medical care. WESW with secondary education (ß = 0.928, 95% CI = 0.007, 1.849) were associated with increased access to medical care. WESW with high asset ownership (ß = -1.154, 95% CI= -1.903, -0.405), high family cohesion (ß = -0.069, 95% CI= -0.106, -0.031), and high domestic violence attitudes (ß = -0.253, 95% CI= -0.438, -0.068) were associated with decreased access to medical care. The findings emphasize the critical need for targeted family strengthening interventions to enhance family support for WESW and address domestic violence.


Assuntos
Infecções por HIV , Acessibilidade aos Serviços de Saúde , Profissionais do Sexo , Estigma Social , Humanos , Feminino , Adulto , Estudos Transversais , Uganda , Pessoa de Meia-Idade , Adolescente , Profissionais do Sexo/psicologia , Profissionais do Sexo/estatística & dados numéricos , Adulto Jovem , Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Violência Doméstica/psicologia , Violência Doméstica/estatística & dados numéricos , Fatores Socioeconômicos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
2.
Soc Sci Med ; 348: 116846, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38581814

RESUMO

Women engaged in sex work (WESW) are at heightened risk of experiencing intimate partner violence (IPV) compared to women in the general population. This study examines the impact of an economic empowerment intervention on IPV among WESW in Southern Uganda. We used data from 542 WESW in Southern Uganda recruited from 19 HIV hotspots between June 2019 and March 2020. Eligible participants were 18+ years old, engaged in sex work-defined as vaginal or anal sexual intercourse in exchange for money, alcohol, or other goods, reported at least one episode of unprotected sexual intercourse in the past 30 days with a paying, casual, or regular sexual partner (spouse, main partner). We analyzed data collected at baseline, 6, and 12months of follow up. To examine the impact of the intervention on IPV, separate mixed-effects logistic regression models were run for each type of IPV (physical, emotional, and sexual) as experienced by participants in the last 90 days. Results show that the intervention was efficacious in reducing emotional and physical IPV as evidenced by a statistically significant intervention main effect for emotional IPV, χ2(1) = 5.96, p = 0.015, and a significant intervention-by-time interaction effect for physical IPV, χ2(2) = 13.19, p < 0.001. To qualify the intervention impact on physical IPV, pairwise comparisons showed that participants who received the intervention had significantly lower levels of physical IPV compared to those in the control group at six months (contrasts = -0.12 (95% CI: -0.22, -0.02), p = 0.011). The intervention, time, and intervention-by-time main effects for sexual IPV were not statistically significant. Our findings suggest economic empowerment interventions as viable strategies for reducing emotional IPV among WESW. However, it is also essential to understand the role of interventions in addressing other forms of IPV especially for key populations at high risk of violence, HIV, and STI. The study was registered at ClinicalTrials.gov, ID: NCT03583541.


Assuntos
Empoderamento , Violência por Parceiro Íntimo , Profissionais do Sexo , Humanos , Feminino , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/estatística & dados numéricos , Uganda , Adulto , Profissionais do Sexo/psicologia , Profissionais do Sexo/estatística & dados numéricos , Adolescente , Adulto Jovem , Trabalho Sexual/psicologia , Trabalho Sexual/estatística & dados numéricos , Pessoa de Meia-Idade , Parceiros Sexuais/psicologia
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