Stigma and unmet sexual and reproductive health needs among international migrant sex workers at the Mexico-Guatemala border.

Abstract

To explore international migrant sex workers' experiences and narratives pertaining to the unmet need for and access to sexual and reproductive health (SRH) at the Mexico-Guatemala border. An inductive qualitative analysis was conducted based on ethnographic fieldwork (2012-2015) including participant observation and audio-recorded in-depth interviews. The participants were female sex workers aged 18years or older and international migrants working at the Mexico-Guatemala border. In total, 31 women were included. The greatest areas of unmet need included accessible, affordable, and nonstigmatizing access to contraception and treatment of sexually transmitted infections. On both sides of the border, poor information about the health systems, services affordability, and perceived stigma resulted in barriers to access SRH services, with women preferring to access private doctors in their destination country or delaying uptake of until their next trip home. Financial barriers prevented women from accessing needed services, with most only receiving SRH services in their destination country through public health regulations surrounding sex work or as urgent care. There is a crucial need to avoid prioritizing vertical disease-specific services and to promote access to rights-based SRH services for migrant sex workers in both home and destination settings.