Tuberculosis Screening among Bolivian Sex Workers & Their Children

Abstract

Bolivian sex workers were more likely than other employed women to report tuberculosis screening only if they reported HIV screening. Of all women with household tuberculosis exposure, <40% reported screening for themselves or their children. Coupling tuberculosis screening with sex workers' mandatory HIV screenings may be a cost-efficient disease-control strategy.

Bolivia has the Western Hemisphere’s second highest tuberculosis (TB) incidence and prevalence [1]. The city of El Alto (population 843,934 [2]) has been recognized as a TB epicenter [3] with poor indices of disease control and detection [4]. Commercial sex workers (CSWs) have multiple TB risk factors—socioeconomic marginalization, crowded workplaces, limited healthcare access, and high HIV infection risk [5], [6] and [7]—but their TB screening practices have been described in only one study, which demonstrated under-screening among Mexican CSWs [8]. TB screening, household exposure, and disease were assessed among El Alto’s CSWs and their children by comparing them with a group of women in other professions (controls) and their children.

Full article at:   http://goo.gl/ywZLp4

By:   Chiang SS¹, Paulus JK², Huang CC³, Newby PK⁴, Castellón Quiroga D⁵, Boynton-Jarrett R⁴, Antkowiak L⁶.

¹Boston University School of Medicine, Division of General Pediatrics, 850 Harrison Avenue, 5th Floor, Boston, MA 02118, USA; Boston Children's Hospital, Department of Medicine, 300 Longwood Avenue, Boston, MA 02115, USA. Electronic address: schiang@alumni.stanford.edu.

²Tufts Clinical and Translational Science Institute, Tufts Medical Center, 35 Kneeland Street, 8th-11th Floors, Boston, MA 02111, USA.

³Department of Medicine, Lahey Clinic, 41 Burlington Mall Road, Burlington, MA 01805, USA.

⁴Boston University School of Medicine, Division of General Pediatrics, 850 Harrison Avenue, 5th Floor, Boston, MA 02118, USA.

⁵Independent Consultant, La Paz, Bolivia.

⁶Boston University School of Medicine, Division of General Pediatrics, 850 Harrison Avenue, 5th Floor, Boston, MA 02118, USA; Boston Children's Hospital, Department of Medicine, 300 Longwood Avenue, Boston, MA 02115, USA.

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An Ethnographic Study of HIV/AIDS among Ayoreo Sex Workers: Cultural Factors & Risk Perception

Abstract

AIMS AND OBJECTIVES:

To describe and understand Ayoreo sex workers' perceptions of HIV/AIDS and to identify factors that may affect the prevention of risk behaviours.

BACKGROUND:

According to recent HIV/AIDS incidence reports, being female, indigenous and a sex worker means belonging to a maximum-risk group, left in the background in terms of strategies for the fight against HIV. Although there has been research into intervention models in these populations, it is important to detail the perceptions of the problem from the perspective of sex workers from the affected ethnic groups.

DESIGN:

This study used an ethnographic methodology that included participant observation and semi-structured interviews.

METHODS:

The research was conducted in two phases. First, participant observation was chosen to access and observe the behaviour of Ayoreo sex workers. The second phase was a semi-structured interview with sex workers and key informants. The interviews, together with the field notes, were transcribed and analysed, following inductive strategies to find emerging themes.

RESULTS:

Here, we present the results related to four emerging themes: the cultural acceptance of sex work as a useful economic activity; the lack of concern for sexually transmitted illnesses and the stigmatisation of people who are HIV seropositive; external factors that increase vulnerability such as difficulties in using a condom; and conflictive and unbalanced relationships between the Ayoreo people and the health system and health professionals.

CONCLUSIONS:

The health- and sexual reproduction-related culture, the knowledge and attitudes of sex workers, external factors, and relationships with the health system and health professionals continue to place Ayoreo sex workers in high-risk conditions in relation to sexually transmitted diseases and HIV/AIDS.

RELEVANCE TO CLINICAL PRACTICE:

Employing cultural care as its base, nursing could develop programmes and interventions culturally adapted for the prevention of disease and the promotion of health in these populations.

Purchase full article at:   http://goo.gl/ziaUAz

By:   López-Entrambasaguas OM¹, Granero-Molina J, Fernández-Sola C.

¹High Guadalquivir Public Hospital, Andújar, Jaén, Spain.

 

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