Abstract
BackgroundIn the context of an operational research project in Tete, Mozambique, use of, and barriers to, HIV and sexual and reproductive health (HIV/SRH) commodities and services for female sex workers (FSWs) were assessed as part of a baseline situational analysis.MethodsIn a cross-sectional survey 311 FSWs were recruited using respondent driven sampling and interviewed face-to-face, and three focus group discussions were held with respectively 6 full-time Mozambican, 7 occasional Mozambican and 9 full-time Zimbabwean FSWs, to investigate use of, and barriers to, HIV/SRH care.ResultsThe cross-sectional survey showed that 71 % of FSWs used non-barrier contraception, 78 % sought care for their last sexually transmitted infection episode, 51 % of HIV-negative FSWs was tested for HIV in the last 6 months, 83 % of HIV-positive FSWs were in HIV care, 55 % sought help at a health facility for their last unwanted pregnancy and 48 % after sexual assault, and none was ever screened for cervical cancer. Local public health facilities were by far the most common place where care was sought, followed by an NGO-operated clinic targeting FSWs, and places outside the Tete area. In the focus group discussions, FSWs expressed dissatisfaction with the public health services, as a result of being asked for bribes, being badly attended by some care providers, stigmatisation and breaches of confidentiality. The service most lacking was said to be termination of unwanted pregnancies.ConclusionsThe use of most HIV and SRH services is insufficient in this FSW population. The public health sector is the main provider, but access is hampered by several barriers. The reach of a FSW-specific NGO clinic is limited. Access to, and use of, HIV and SRH services should be improved by reducing barriers at public health facilities, broadening the range of services and expanding the reach of the targeted NGO clinic.
Highlights
In the context of an operational research project in Tete, Mozambique, use of, and barriers to, human immunodeficiency virus (HIV) and sexual and reproductive health (HIV/SRH) commodities and services for female sex workers (FSWs) were assessed as part of a baseline situational analysis
The extent of the use of HIV and sexual and reproductive health (HIV/SRH) commodities and services by FSWs was assessed between August 2013 and April 2014 through a cross-sectional survey, using respondent-driven sampling
The median number of years living at their current residence was 4 and 2 years (Mozambican and foreign FSWs, respectively)
Summary
In the context of an operational research project in Tete, Mozambique, use of, and barriers to, HIV and sexual and reproductive health (HIV/SRH) commodities and services for female sex workers (FSWs) were assessed as part of a baseline situational analysis. The area ( on referred to as ‘Tete’) has 8 public health centres, 1 public hospital, and 4 private clinics, and in Moatize there is a stand-alone drop-in clinic for most-atrisk populations that offers information, education and communication, condoms, STI care, contraceptive services, and HIV testing services (HTS) during the evening (4–10 PM), and is called the Night Clinic. It is operated by a non-governmental organisation, in collaboration with the district health department [13]
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