Abstract
A qualitative study using in-depth interviews explored the perceptions and views of brothel leaders and HIV program experts on the acceptability and adoptability of using gatekeepers in interventions aimed at improving Female Sex Workers’ (FSWs) condom use in Nigeria. Brothel leaders are an influential group within the FSWs’ social and physical environment and their attitudes, beliefs and actions can influence the immediate brothel environment and the adoption of interventions within the brothel. HIV prevention experts make key decisions on the content and strategies adopted for HIV prevention efforts and also influence the design and implementation of HIV prevention strategies within programs. Four themes illustrating the benefits and barriers of the inclusion of gatekeepers within the immediate environment of the FSW were identified. Results show that brothel leadership inclusion in HIV prevention efforts could exert potential positive influence on the immediate brothel environment. Brothel leaders can support the institution of establishment policies supporting consistent condom use by the FSWs, promotion of HIV awareness, resolution of conflicts and harassments, support to new entrants into sex work and the reinforcement of protective behaviors among the FSWs. The decriminalization of sex work and the inclusion of gatekeepers support into country HIV program guidelines may contribute to mitigating prevalent sociocultural factors limiting FSWs’ rights as well as their access to health services. The present study provides insights into the potential positive roles of brothel leaders in improving condom use and other HIV/AIDs related interventions for brothel based FSWs in Abuja, Nigeria from the perspective of brothel leaders and HIV prevention experts.
Highlights
Surveillance data by the Federal Ministry of Health in Nigeria show that Female Sex Workers (FSWs) have a high HIV prevalence and record the second highest prevalence of HIV compared to other sub-populations in the country with a HIV prevalence rate of 19.4%. (FMOH, 2014) An influential group of people within the Female Sex Workers’ (FSWs)’ social and physical environment, who serve as gatekeepers, are those managing the FSWs
The interviews focused on how brothel leaders and HIV prevention experts perceive the roles of gatekeepers in the promotion of consistent condom use by FSWs
This study focuses on the perspectives of brothel leaders and HIV prevention experts on gatekeeper inclusion to current HIV prevention interventions for FSWs
Summary
Surveillance data by the Federal Ministry of Health in Nigeria show that Female Sex Workers (FSWs) have a high HIV prevalence and record the second highest prevalence of HIV compared to other sub-populations in the country with a HIV prevalence rate of 19.4%. (FMOH, 2014) An influential group of people within the FSWs’ social and physical environment, who serve as gatekeepers, are those managing the FSWs (e.g., managers, chairladies, owners of establishments/brothels). (FMOH, 2014) An influential group of people within the FSWs’ social and physical environment, who serve as gatekeepers, are those managing the FSWs (e.g., managers, chairladies, owners of establishments/brothels). They have a reciprocal financial relationship with FSWs and rely on FSWs to make money. The vulnerability of FSWs and the increased risks faced as a result of the interplay between their sex, work settings and social factors influencing sex work in the country has been brought to the fore by the HIV epidemic.
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