Barriers and facilitators of access to HIV, harm reduction and sexual and reproductive health services by women who inject drugs: role of community-based outreach and drop-in centers
Barriers and facilitators of access to HIV, harm reduction and sexual and reproductive health services by women who inject drugs: role of community-based outreach and drop-in centers
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DOI：
10.1080/09540121.2017.1394965
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发表时间：
2018-01-01
影响因子：
1.7
通讯作者：
Mburu, Gitau
中科院分区：
文献类型：
--
作者：
Ayon, Sylvia;Ndimbii, James;Mburu, Gitau
关于注射毒品的妇女以及如何使减少伤害服务更加以妇女为中心的数据有限。这项研究探讨了肯尼亚注射吸毒妇女在获得艾滋病毒、减少伤害以及性健康和生殖健康服务方面的经验。共有45名注射吸毒妇女和5名主要利益攸关方参加了深入访谈和焦点小组讨论。对数据的专题分析表明，耻辱、距离远、缺乏保密性、使用者收费、多次预约、吸毒者不熟悉保健设施、与保健提供者的沟通中断以及保健提供者不了解妇女的需求是阻碍妇女获得保健服务的因素。由外联和救助中心组成的社区服务通过建立信任、对妇女进行健康和权利教育、将妇女与保健设施联系起来、使保健提供者对注射毒品妇女的需求保持敏感、以及将妇女的性健康和生殖健康服务纳入社区减少伤害外联活动，来减少这些障碍。将性健康和生殖健康服务纳入基于社区的减少危害活动，增加了妇女对减少危害干预措施的兴趣和获得这些措施的机会。这些调查结果强调，需要加强以社区为基础的注射吸毒妇女方案，并将性健康和生殖健康服务纳入针头和注射器交换方案。
There is limited data regarding women who inject drugs, and how harm-reduction services can be made more women-centered. This study explored experiences of Kenyan women who inject drugs, with regard to access to HIV, harm reduction and sexual and reproductive health (SRH) services. A total of 45 women who inject drugs and 5 key stakeholders participated in-depth interviews and focus group discussions. Thematic analysis of the data revealed that stigma, long distances, lack of confidentiality, user fees, multiple appointments, drug users' unfamiliarity with health facilities, disconnect in communication with healthcare providers, and healthcare providers' lack of understanding of women's needs were factors that impede women's access to health services. Community-based services, comprising of outreach and drop-in centers mitigate these barriers by building trust, educating women on their health and rights, linking women to health facilities, sensitizing health providers on the needs of women who inject drugs, and integrating women's SRH services into community-based harm-reduction outreach. Inclusion of SRH services into community-based harm-reduction activities increased women's interest and access to harm-reduction interventions. These findings underscore the need to strengthen community-based programming for women who inject drugs, and to integrate SRH services into needle and syringe exchange programs.