Reforming the registration policy of female sex workers in Senegal? Evidence from a discrete choice experiment.
Reforming the registration policy of female sex workers in Senegal? Evidence from a discrete choice experiment.
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DOI：
10.1371/journal.pone.0289882
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
有证据表明，在女性性工作者中治疗性传播感染是减少艾滋病毒/艾滋病传播的一种具有成本效益的战略。塞内加尔是唯一一个性工作受公共卫生政策管理的非洲国家，该政策旨在监测和常规治疗性传播感染。法律要求性工作者至少21岁，在健康中心和警察那里登记，携带最新的登记手册，参加每月的健康检查，性传播感染检测呈阴性。尽管注册可以带来健康和法律上的好处，但塞内加尔80%的性服务工作者没有注册。因此，这项政策的潜在健康益处并未实现。为了了解为什么FSWs不想注册，并确定将提高塞内加尔FSWs注册率的政策变化，我们设计并实施了一项离散选择实验(DCE)，由241个已注册和273个未注册的FSWs完成。参与者在一系列假设但现实的注册政策变化之间做出了选择。使用条件Logit模型对DCE数据进行分析。结果强调，卫生设施的保密性是一个重要因素，注册和未注册的卫生服务分别为26.0个百分点(Pp)和22.1个百分点(Pp)更有可能倾向于保证卫生中心保密性的政策。同样，这两个群体都倾向于只将他们的健康记录保存在健康中心，而不是警察那里。可以在不修改法律的情况下实施几项干预措施，以提高妇女地位委员会的登记率并改善他们的福祉。例如，在登记政策包中引入心理社会支持，用二维码取代登记手册，使用电子医疗档案，将性服务工作者的常规探视与产妇保健预约相结合，以增加保密性，这些都有可能鼓励妇女服务工作者登记。
Evidence suggests that treating sexually transmitted infections (STIs) amongst female sex workers (FSWs) is a cost-effective strategy to reduce the spread of HIV/AIDS. Senegal is the only African country where sex work is regulated by a public health policy which aims to monitor and routinely treat STIs. The law requires FSWs to be at least 21 years old, register with a health centre and the police, carry an up-to-date registration booklet, attend monthly health check-ups, and test negative for STIs. Despite health and legal benefits of registration, 80% of FSWs in Senegal are not registered. Hence, the potential health benefits of the policy have not materialised. To understand why FSWs do not want to register and to define policy changes that would increase the registration rate of FSWs in Senegal, we designed and implemented a discrete choice experiment (DCE) completed by 241 registered and 273 non-registered FSWs. Participants made choices between a series of hypothetical but realistic registration policy changes. Conditional logit models were used to analyse the DCE data. The results highlighted that confidentiality at the health facility was an important element, registered and non-registered FWs were respectively 26.0 percentage points (pp) and 22.1 pp more likely to prefer a policy that guaranteed confidentiality at the health centre. Similarly, both groups preferred a policy where their health record was only held at the health centre and not with the police. Several interventions to increase FSW registration rate and improve their wellbeing may be implemented without modifying the law. For example, the introduction of psychosocial support in the registration policy package, replacing the registration booklet by a QR code, the use of electronic medical files and the integration of FSWs routine visits with maternal health appointments to increase confidentiality have the potential to encourage registration of FSWs.
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影响因子：
1.2
作者：
Foley, Ellen E.;Nguer, Rokhaya
通讯作者：
Nguer, Rokhaya
影响因子：
3.8
作者：
Alary, Michel;Lowndes, Catherine M.;Nagot, Nicolas
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Nagot, Nicolas
影响因子：
2.1
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Ito S;Lépine A;Treibich C
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影响因子：
168.9
作者：
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通讯作者：
Beyrer, Chris
影响因子：
15.8
作者：
Platt, Lucy;Grenfell, Pippa;Crago, Anna-Louise
通讯作者：
Crago, Anna-Louise