Girls looking for sex in st petersburg ak

Added: Boruch Gambill - Date: 29.08.2021 04:47 - Views: 22548 - Clicks: 8097

Try out PMC Labs and tell us what you think. Learn More. Stigma associated with HIV and risk behaviors is known to be a barrier to health care access for many populations. Less is known about female sex workers FSW in Russia, a population that is especially vulnerable to HIV-infection, and yet hard-to-reach for service providers. We administered a questionnaire to FSW to better understand how stigma and discrimination influence HIV service utilization. Logistic regression analysis indicated that HIV-related stigma is negatively associated with uptake of HIV testing, while sex work-related stigma is positively associated with HIV testing.

While decreasing societal stigma should be a long-term goal, programs that foster inclusion of marginalized populations in Russian health care settings are urgently needed. Petersburg, the second largest city in Russia, has consistently experienced one of the largest HIV prevalence rates within the country 23. These official statistics represent the of registered cases, and the s are believed to be much higher 5. Petersburg are HIV-positive 8. Petersburg is Additionally, the sexual transmission of the virus is on the rise, and commercial sex work may be one of the reasons 2 In St.

Studies of IDUs based in St. Petersburg have HIV The combination of involvement in injection drug use and commercial sex work increases the susceptibility to HIV-infection among these women. The male clients of sex workers in Russia are a potential bridge population for transmitting HIV-infection to their non-sex worker partners While HIV testing services and HIV treatment are available in Russia, it has been shown that these services are not adequately reaching the populations most vulnerable and in need. Inonly Approximately one-quarter of IDUs in St.

There is a dearth of information about the reasons for this underutilization. It is important to understand the reasons why the most vulnerable populations are not accessing testing and treatment services in St. One reason that vulnerable populations may not be accessing needed HIV services is stigma and discrimination. Stigma can be defined as a process of labeling, stereotyping, separating, experiencing loss of status for the stigmatized, and Girls looking for sex in st petersburg ak of power Stigma around HIV in Russia is high and has been shown to inhibit vulnerable populations from seeking HIV prevention Girls looking for sex in st petersburg ak testing services 20 In addition, discrimination against IDUs from health care professionals has also been shown to adversely influence access to HIV services in Russia 10 However, to our knowledge, studies have not yet been conducted that look at stigma and discrimination specifically among female injection drug users or sex workers in St.

Petersburg, Russia. The objective of this paper is to examine the extent of female sex workers perceived stigma and experienced discrimination in the health care setting in St. We aimed to describe the types of stigma and discrimination female sex workers experience in the health care setting, and to determine the association between stigma and discrimination and utilization of HIV testing services.

Petersburg State University approved all protocols for the research. Verbal informed consent was obtained from each participant and anonymity of participation was guaranteed. The study de consisted of a cross-sectional, interviewer-administered questionnaire to female sex workers who were over 18 years of age and residing in St.

Participants were recruited through two organizations that operate an outreach van service to street-based female sex workers in St. Participants were recruited until we reached a point of sampling saturation, meaning that we were no longer getting any new participants in any of the outreach services destinations. The first author and two research assistants at each organization administered the questionnaire. Interviews were conducted in a private space on the outreach van or outside, and lasted approximately 15—20 minutes. Measures of stigma and discrimination were based on research from international settings and among Russian IDUs when available.

The HIV-related stigma scale was selected because it was deed to be used across multiple cultural settings for more information, see Genberg et al. The following information was collected from participants who reported receiving an HIV diagnosis: place of diagnosis, history of receiving HIV services, and perceived stigma after diagnosis. Demographic information was also collected. Frequency distributions were used to describe the sample.

These descriptive data are important given that there has been such little research done with this specific population in St. Cronbach alphas were calculated for each of the scales to assess internal validity and to determine whether or not a composite score could be used. The scale used to measure HIV-related stigma had a Cronbach alpha of 0. The sex work-related stigma scale demonstrated a Cronbach alpha of 0.

Items for both of the scales were scored based on a five-point Likert scale. Therefore, the highest composite score possible for the HIV-related stigma scale was 65 and the highest composite score possible for the sex work-related stigma scale was Logistic regression was used to determine which factors were ificantly associated with the primary outcome variable of interest, HIV testing. Given that nearly all of the participants reported that they received an HIV test at some point, in the logistic regression analysis this variable was dichotomized as recent test versus no recent test.

Observations were excluded in the logistic regression analysis if a participant reported an HIV-positive status and had tested more than six months ago. Independent variables included in the regression model were used to measure potential confounders, including age, residency, marital status, time spent in sex work, and the of years using drugs. Age, time spent in sex work, and time spent using drugs were measured as continuous variables. Logit step tests were used to confirm the assumption of linearity. Based on this, age remained a continuous variable in the logistic regression models.

However, the variables of time spent involved in sex work and using drugs violated the assumption of linearity in the logits. Time of sex work was categorized as being involved in sex work for at least five years or being involved in sex work for less than five years. Time of drug use was dichotomized as using drugs for more than four years or for up to four years. The logistic regression model included the scores on the HIV-related stigma scale and the sex work stigma scale and questions on being discriminated against in the health care setting.

Both the HIV-related stigma scale and the sex work stigma scale were checked to ensure that they did not violate the assumption of linearity. All variables were included in the model and backward logistic regression was used determine the final model. Finally, descriptive statistical analysis was done to describe the sub-population of the sample who reported a positive HIV serostatus.

A bivariate analysis was done to compare perceived stigma level and discrimination in the health care setting between those with a positive HIV serostatus and those with a negative HIV serostatus. One hundred thirty nine female sex workers completed the interviewer-administered questionnaire. The demographics characteristics of our sample are provided in Table 1.

The female sex workers in this study were asked about their opinions of people living with HIV. Stigma and discrimination were reported by the female sex workers living with HIV. The mean score on the HIV-related stigma scale was 33 of a possible 65 points scores ranged from 13— The mean score on the sex work-related stigma scale was 19 of a possible 25 points. Table 2. Experienced discrimination, measured as having been refused medical care, was positively correlated with having had a recent HIV test.

And fear of discrimination, measured as avoided medical care because of fear of how one would be treated, was also positively correlated with having had a recent HIV test. However, neither of these associations was ificant. Age and the length of time using drugs were the only covariates found to be ificantly associated with recent HIV testing. Female sex workers in St. Petersburg reported high levels of perceived stigma within the health care setting related to sex work, injection drug use, and HIV. Female sex workers who Girls looking for sex in st petersburg ak HIV-positive were more likely than HIV-negative sex workers to have experienced discrimination in the health care setting.

These findings are consistent with studies on HIV-related stigma as a barrier to services both among other populations in Russia 102023 and among female sex workers in other countries 25 Sex work-related stigma was positively correlated with getting a recent HIV test. Our unexpected finding was similar to a recent study of female sex workers in India, which found that prior utilization of health care services increased sex work-related stigma in the community One explanation may be that sex workers may feel that they can better hide involvement in sex work from health care providers, but it is more difficult to hide an HIV status.

Therefore, perceived stigma specific to sex work is not making women less likely to go for an HIV test. It is possible that there are other variables, that we did not measure, which are confounding the association shown in this study. It could also be that during HIV testing and counseling they have disclosed that they are sex workers and have been treated poorly, thus increasing their levels of perceived sex work-related stigma.

Further studies are needed to more fully explain the relationship between higher perceived stigma related to sex work and greater probability of having had a recent HIV test. More research is also needed to understand if and how stigmas associated with injection drug use, sex work, and HIV are distinct or related in regard to how they influence utilization of services.

Our study adds to the growing body of research on HIV-related stigma in Russia. Recent research in St. Petersburg demonstrated that HIV-related stigma is very high and can be a major barrier in access to treatment and care services for injections drug users It has been noted that stigma and discrimination are challenges to providing effective and comprehensive HIV treatment for sex workers living with HIV in Russia The of our study provide more specific information on the correlation between perceived stigma and discrimination and the utilization of HIV services for the highly vulnerable population of street-based female sex workers in St.

We recognize the need for more precise measures of stigma among highly vulnerable populations, including injection drug users and sex workers. Our findings are consistent with these studies. Our study fills two important gaps in this growing body of knowledge on stigma and HIV in Russia because it focused specifically on female sex workers and included both women who are living with HIV and women who are HIV-negative.

Study limitations should be mentioned. This study was cross-sectional and therefore, explicit conclusions could not be drawn regarding the casual pathway between the hypothesized factors and being tested for HIV. Self-reported information is subject to potential social desirability bias and recall bias in reporting perceptions of stigma, experienced discrimination, and HIV status. Numerous measures were taken to minimize these biases including creating a comfortable and private atmosphere, forming questions in a non-judgmental manner, establishing trust between the interviewer and participants, and reassuring participants of confidentiality and anonymity.

There were some limitations in the recruitment process that are unique to working with vulnerable populations. Recruitment was extremely difficult given that sex work is not legal in Russia and the stigma associated with this profession. There are female sex workers who do not access outreach services, and these women were not included in this study. Given that participation was entirely voluntary and no information was collected on women who declined an invitation to participate, no conclusions can be drawn as to whether or not there were any differences between those who chose to participate and those who declined participation.

A larger sample size may allow for stratified analyses to determine if there are subgroups of sex workers based on age or length of time involved in sex work that might be less likely to utilize HIV services because of fear of stigma and discrimination.

Further research recommendations include conducting research with other sex workers, who may be even more difficult to reach such as indoor or brothel-based sex workers, victims of sex trafficking, and male sex workers. Our study adds to the growing body of evidence that particularly vulnerable populations, such as female sex workers and injection drug users in Russia may not feel comfortable accessing health services, discussing their social and behavioral risks for HIV with providers, or testing for HIV in settings were their identity is known.

Laws and policies should be developed that promote the universal acceptance of people seeking HIV testing, prevention and treatment services. This is especially pertinent in Russia where free HIV testing in state-run facilities requires a person to relinquish anonymity and a person living with HIV will need to register into the state system in order to access state-sponsored treatment and care. Increased efforts to improve the knowledge and sensitivity of Russian health care providers should be implemented. Given the current situation, more options, such as outreach services and places for anonymous HIV testing, should be expanded in Russia.

The rights of vulnerable populations to be protected from stigma and discrimination in all health care settings must be promoted now in order to get more people to prevent HIV infection of themselves and others, learn their HIV status, and access available treatment and care. The content of the manuscript is solely the responsibility of the authors and does not necessarily represent the views of the funding agencies. National Center for Biotechnology InformationU. AIDS Behav. Author manuscript; available in PMC Oct 1.

Elizabeth J. King1 Suzanne Maman2 J. Michael Bowling2 Kathryn E. Moracco2 and Viktoria Dudina 3. Michael Bowling. Kathryn E. Viktoria Dudina 3 St. Petersburg, Russia Find articles by Viktoria Dudina. Author information Copyright and information Disclaimer.

Corresponding Author: Elizabeth J. Copyright notice. See other articles in PMC that cite the published article. Abstract Stigma associated with HIV and risk behaviors is known to be a barrier to health care access for many populations. Keywords: female sex workers, HIV testing, stigma and discrimination, Russia. Petersburg Open in a separate window.

Girls looking for sex in st petersburg ak

email: [email protected] - phone:(427) 256-3545 x 7622

Gangbang hardcore and cops punish Stephanie West in Im Your Pussy Now