Motivators & Barriers to HIV Testing among Street-Based Female Sex Workers in St. Petersburg, Russia

Female sex workers are particularly susceptible to HIV-infection in Russia. However, a dearth of information exists on their utilisation of HIV services. 

A mixed-methods, cross-sectional study was conducted to examine motivators and barriers to HIV testing among street-based sex workers in St. Petersburg, Russia. The health belief model was the theoretical framework for the study. Twenty-nine sex workers participated in in-depth interviews, and 139 sex workers completed interviewer-administered surveys between February and September 2009. 

Barriers to getting an HIV test were fear of learning the results, worrying that other people would think they were sick, and the distance needed to travel to obtain services. Motivators for getting tested were protecting others from infection, wanting to know one's status and getting treatment if diagnosed. Logistic regression analysis demonstrated that knowing people living with HIV and length of time since start of injection drug use were significantly associated with recently getting tested. 

These results are important to consider when developing public health interventions to help female sex workers in Russia learn their HIV status and get linked to care and treatment services if needed.

Purchase full article at:   http://goo.gl/20JLsI

By:   King EJ1, Maman S1, Dudina VI2, Moracco KE1, Bowling JM1.

• 1 Department of Health Behavior , Gillings School of Global Public Health, University of North Carolina-Chapel Hill , Chapel Hill , NC , USA.
• 2 Department of Sociology , St. Petersburg State University , St. Petersburg , Russia. 

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Development & Psychometric Testing of a Barriers to HIV Testing Scale among Individuals with HIV Infection in Sweden; The Barriers to HIV Testing Scale-Karolinska Version

Background

Barriers to HIV testing experienced by individuals at risk for HIV can result in treatment delay and further transmission of the disease. Instruments to systematically measure barriers are scarce, but could contribute to improved strategies for HIV testing. Aims of this study were to develop and test a barriers to HIV testing scale in a Swedish context.

Methods

An 18-item scale was developed, based on an existing scale with addition of six new items related to fear of the disease or negative consequences of being diagnosed as HIV-infected. Items were phrased as statements about potential barriers with a three-point response format representing not important, somewhat important, and very important. The scale was evaluated regarding missing values, floor and ceiling effects, exploratory factor analysis, and internal consistencies.

Results

The questionnaire was completed by 292 adults recently diagnosed with HIV infection, of whom 7 were excluded (≥9 items missing) and 285 were included (≥12 items completed) in the analyses. The participants were 18–70 years old (mean 40.5, SD 11.5), 39 % were females and 77 % born outside Sweden. Routes of transmission were heterosexual transmission 63 %, male to male sex 20 %, intravenous drug use 5 %, blood product/transfusion 2 %, and unknown 9 %. All scale items had <3 % missing values. The data was feasible for factor analysis (KMO = 0.92) and a four-factor solution was chosen, based on level of explained common variance (58.64 %) and interpretability of factor structure. The factors were interpreted as; personal consequences, structural barriers, social and economic security, and confidentiality. Ratings on the minimum level (suggested barrier not important) were common, resulting in substantial floor effects on the scales. The scales were internally consistent (Cronbach’s α 0.78–0.91).

Conclusions

This study gives preliminary evidence of the scale being feasible, reliable and valid to identify different types of barriers to HIV testing.

Full article at:   http://goo.gl/FQ5LN9

By:  Maria Wiklander, Johanna Brännström, Veronica Svedhem, and Lars E. Eriksson

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden

Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden

Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden

School of Health Sciences, City University London, London, UK

Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23300, SE-141 83 Huddinge, Sweden

Maria Wiklander, Phone: + 46 707 27 10 13, Email: es.ik@rednalkiw.airam.

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