Factors influencing effective utilization of Hiv/sti comprehensive health services by sex workers in Nairobi, Kenya

Abstract

The great majority of HIV infections globally are due to sexual transmission. The links between sex work and HIV/AIDS have been a central concern in prevention and care efforts in many countries. In the wake of HIV, there has been a renewed engagement with sex workers as subjects of research. In Kenya, a majority of women exchange sex for money, gifts or favors and this makes them vulnerable to HIV/STI infection. Like in most developing countries, sex work is stigmatized and with the legislative restriction, sex workers fear seeking treatment from recognized health facilities. The study sought to establish the factors that have contributed to minimal utilization of these services by sex workers in Nairobi. The research was designed as a cross sectional descriptive study. The target population was sex workers operating in Nairobi’s CBD, Ngara, Eastleigh and Industrial Area. The study focused more on Nairobi sex workers who are mostly brothel based, street and bar based within the catchment area of non-state owned facilities. From the target population of thirty thousand possible respondents, the researcher purposively interviewed specific respondents located in Nairobi’s CBD, Ngara, Eastleigh and Industrial Area. A sample size of 382 respondents was appropriate to adequately represent a cross-section of the population at 95% confidence level. The study collected both primary and secondary data. Data collected was mainly quantitative and it was analyzed by descriptive analysis techniques. Variables for quantitative data were created using statistical tools such as Statistical Package for Social Sciences (SPSS),which helped to reduce data to manageable summaries. On the other hand, qualitative data was analyzed using content analysis. The study concludes that sex workers are aware of the risks involved in this profession as concerns HIV and STIs and thus they take the step of using condom as one of the ways of preventing HIV and STIs. The situation of being a sex worker affects the ability to access assistance on HIV/AIDS Prevention. Awareness of comprehensive HIV/STI services affects their utilization of service. Type of sex work affects utilization of HIV/STI comprehensive health services among sex workers. Distance of comprehensive health centers influences the utilization of health services. Possible and appropriate sustained activities to bring behavior change regarding stigma and discrimination related with HIV/AIDS and VCT is necessary using Discs alongside other available health facilities. Interventions designed to prevent HIV infection among sex workers must take into account the context in which sex workers are working, and the specific practices of individual sex workers. There is need for awareness creation among sex workers through emphasis on the power of sex workers to help stop the spread of HIV. Possible and appropriate activities should be focused on lower educational status and unmarried individuals