Barriers to access and utilisation of HIV/STIs prevention and care services among transwomen sex workers in the greater Kampala metropolitan area, Uganda
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
BMC infectious diseases
Abstract
Trans-women sex workers bear the greatest brunt of HIV and other sexually transmitted infections (STI). Trans-women are 49 times more at risk of HIV infections compared to the general population. However, they remain underserved and continue to grapple with access to and utilization of HIV/STI prevention services. This study explored barriers to access and utilization of HIV/STI prevention services and associated coping mechanisms. This exploratory qualitative study was conducted among trans-women sex workers in the Greater Kampala Metropolitan area, Uganda. A total of 22 in-depth interviews, 6 key informant interviews and 9 focus group discussions were conducted to obtain data on barriers to access and utilization of HIV and other STI prevention and care services, and coping strategies of trans-women sex workers. Data were analyzed through thematic analysis
using a hybrid of inductive and deductive approaches. Individual level barriers to access and utilization of HIV/STI prevention and care services included internalized stigma and low socio-economic status. Healthcare system barriers included social exclusion and lack of recognition by other key population groups; stigmatisation by some healthcare providers; breach of confidentiality by some healthcare providers; limited hours of operation of some key population-friendly healthcare facilities; discrimination by
straight patients and healthcare providers; stockout of STI drugs; inadequate access to well-equipped treatment centres
and high cost of drugs. At community level, transphobia hindered access and utilisation of HIV/STI prevention and care
services. The coping strategies included use of substitutes such as lotions, avocado or yoghurt to cope with a lack of
lubricants. Herbs were used as substitutes for STI drugs, while psychoactive substances were used to cope with stigma
and discrimination, and changing the dress code to hide their preferred gender identity
Description
Keywords
HIV/AIDS, Sexually transmitted infections, Trans-women, Sex work, Uganda
Citation
Ssekamatte, T., Isunju, J. B., Naume, M., Buregyeya, E., Mugambe, R. K., Wanyenze, R. K., & Bukenya, J. N. (2020). Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda. BMC infectious diseases, 20(1), 1-15.https://doi.org/10.1186/s12879-020-05649-5