The relationship between health worker stigma and uptake of HIV counseling and testing and utilization of non-HIV health services: the experience of male and female sex workers in Kenya.

The barrier HIV-stigma presents to the HIV treatment cascade is increasingly documented; however less is known about female and male sex worker engagement in and the influence of sex-work stigma on the HIV care continuum. While stigma occurs in all spheres of life, stigma within health services may...

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Publicado en:AIDS Care Vol. 29; no. 11; pp. 1364 - 1373
Autores principales: Nyblade, Laura, Reddy, Aditi, Mbote, David, Kraemer, John, Stockton, Melissa, Kemunto, Caroline, Krotki, Karol, Morla, Javier, Njuguna, Stella, Dutta, Arin, Barker, Catherine
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Nov2017
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Taylor & Francis Ltd
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        10.1080/09540121.2017.1307922
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        atl: The relationship between health worker stigma and uptake of HIV counseling and testing and utilization of non-HIV health services: the experience of male and female sex workers in Kenya.
      aug:
        au:
          Nyblade, Laura
          Reddy, Aditi
          Mbote, David
          Kraemer, John
          Stockton, Melissa
          Kemunto, Caroline
          Krotki, Karol
          Morla, Javier
          Njuguna, Stella
          Dutta, Arin
          Barker, Catherine
        affil: Global Health Division, International Development Group, RTI International, Washington, USA
      sug:
        subj:
          Stigma
          Health Resource Utilization Kenya
          Professional-Patient Relations Kenya
          Counseling
          HIV Infections Diagnosis
          Sex Work
          Attitude of Health Personnel Kenya
          Human
          Kenya
          Male
          Female
          Patient Attitudes Evaluation
          Snowball Sample
          Descriptive Research
          Descriptive Statistics
          Odds Ratio
          Male
          Female
      ab: The barrier HIV-stigma presents to the HIV treatment cascade is increasingly documented; however less is known about female and male sex worker engagement in and the influence of sex-work stigma on the HIV care continuum. While stigma occurs in all spheres of life, stigma within health services may be particularly detrimental to health seeking behaviors. Therefore, we present levels of sex-work stigma from healthcare workers (HCW) among male and female sex workers in Kenya, and explore the relationship between sex-work stigma and HIV counseling and testing. We also examine the relationship between sex-work stigma and utilization of non-HIV health services. A snowball sample of 497 female sex workers (FSW) and 232 male sex workers (MSW) across four sites was recruited through a modified respondent-driven sampling process. About 50% of both male and female sex workers reported anticipating verbal stigma from HCW while 72% of FSW and 54% of MSW reported experiencing at least one of seven measured forms of stigma from HCW. In general, stigma led to higher odds of reporting delay or avoidance of counseling and testing, as well as non-HIV specific services. Statistical significance of relationships varied across type of health service, type of stigma and gender. For example, anticipated stigma was not a significant predictor of delay or avoidance of health services for MSW; however, FSW who anticipated HCW stigma had significantly higher odds of avoiding (OR = 2.11) non-HIV services, compared to FSW who did not. This paper adds to the growing evidence of stigma as a roadblock in the HIV treatment cascade, as well as its undermining of the human right to health. While more attention is being paid to addressing HIV-stigma, it is equally important to address the key population stigma that often intersects with HIV-stigma.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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