Global Public Health
Volume 14, Issue 10, 2019, Pages 1428-1441

Characterising the relationship between migration and stigma affecting healthcare engagement among female sex workers in Lomé, Togo (Article)

Lasater M.E.* , Grosso A. , Ketende S. , Lyons C. , Pitche V.P. , Tchalla J. , Anato S. , Sodji D. , Nadedjo F. , Baral S.
  • a Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  • b Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  • c Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  • d Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  • e Conseil National de Lutte contre le SIDA du Togo (National AIDS Council), Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo
  • f Espoir Vie, Lomé, Togo
  • g Arc en Ciel, Lomé, Togo
  • h FAMME, Lomé, Togo
  • i FAMME, Kara, Togo
  • j Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States

Abstract

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. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Author Keywords

Migration healthcare engagement Stigma HIV Female sex workers

Index Keywords

chi square test multivariate logistic regression analysis health care personnel correlation analysis interpersonal communication human Health Behavior priority journal Human immunodeficiency virus sex worker sexually transmitted disease Young Adult migrant worker cross-sectional study female clinical evaluation questionnaire high risk population stigma Article adult migration human experiment health care access Togo outcome assessment abortion
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85065302532&doi=10.1080%2f17441692.2019.1611896&partnerID=40&md5=eabcc6a28bf555b4d8ddb01a0adee438
DOI: 10.1080/17441692.2019.1611896
ISSN: 17441692
Original Language: English