Stigma as a barrier to health care utilization among female sex workers and men who have sex with men in Burkina Faso
Stigma as a barrier to health care utilization among female sex workers and men who have sex with men in Burkina Faso
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DOI：
10.1016/j.annepidem.2017.11.009
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发表时间：
2018-01-01
影响因子：
5.6
通讯作者：
Baral, Stefan
中科院分区：
文献类型：
--
作者：
Kim, Hae-Young;Grosso, Ashley;Baral, Stefan
目的：本研究的目的是探讨女性性工作者（FSWs）和男性与男性发生性关系（MSM），包括其他污名类型，自杀意念，并参与社会activity.Methods：FSWs（N = 350）和MSM（N = 330）年龄>= 18岁的患病率和相关性招募在波波-迪乌拉索，布基纳法索。感知的医疗保健耻辱被定义为害怕或避免医疗保健服务，因为有人可能会发现参与者与男性发生性关系（对于MSM）或出售性（对于FSW）。结果：暗娼和男男性行为者的自觉卫生保健污名发生率分别为14.9%（52/350）和24.5%（81/330）;在FSW中，经历或社会耻辱，包括口头骚扰，（调整后的比值比[aOR] = 3.59，95%置信区间[CI] 1.48-8.71），感觉被朋友拒绝（aOR = 2.30，95%CI 1.14-4.64）和感觉警察拒绝保护他们（aOR = 2.58，95%CI 1.27-5.25）与感知的卫生保健污名相关。在MSM人群中，言语骚扰（aOR = 1.95，95%CI 1.09-3.50）和害怕在公共场所行走（aOR = 2.93，95%CI 1.47-5.86）与感知到的医疗污名相关。为了扩大有效艾滋病毒服务的覆盖面，干预措施应纳入全面减轻污名化的办法。(C)2017爱思唯尔公司All rights reserved.
Purpose: The aim of this study is to examine the prevalence and correlates of perceived health care stigma among female sex workers (FSWs) and men who have sex with men (MSM), including other stigma types, suicidal ideation, and participation in social activities.Methods: FSWs (N = 350) and MSM (N = 330) aged >= 18 were recruited in Bobo-Dioulasso, Burkina Faso. Perceived health care stigma was defined as either ever being afraid of or avoiding health care services because someone might find out the participant has sex with men (for MSM) or sells sex (for FSW). Correlates of perceived health care stigma were examined using multivariable logistic regression.Results: The prevalence of perceived health care stigma was 14.9% (52/350) and 24.5% (81/330) in FSWs and MSM, respectively. Among FSWs, experienced or social stigma, including verbal harassment (adjusted odds ratio [aOR] = 3.59, 95% confidence interval [CI] 1.48-8.71), feeling rejected by friends (aOR = 2.30, 95% CI 1.14-4.64), and feeling police refused to protect them (aOR = 2.58, 95% CI 1.27-5.25), was associated with perceived health care stigma. Among MSM, experiencing verbal harassment (aOR = 1.95, 95% CI 1.09-3.50) and feeling scared to walk in public (aOR = 2.93, 95% CI 1.47-5.86) were associated with perceived health care stigma.Conclusions: In these key populations, perceived health care stigma was prevalent and associated with experienced and social stigmas. To increase coverage of effective HIV services, interventions should incorporate approaches to comprehensively mitigate stigma. (C) 2017 Elsevier Inc. All rights reserved.