Open AccessFacilitators and barriers to linkage to HIV care and treatment among female sex workers in a community-based HIV prevention intervention in Tanzania: A qualitative study
Author(s) -
Daniel Nyato,
Soori Nnko,
Albert Komba,
Evodius Kuringe,
Marya Plotkin,
Gaspar Mbita,
Amani Shao,
John Changalucha,
Mwita Wambura
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0219032
Subject(s) - tanzania , human immunodeficiency virus (hiv) , qualitative research , intervention (counseling) , sex workers , medicine , community health workers , gerontology , family medicine , environmental health , nursing , health services , population , sociology , research methodology , socioeconomics , social science
Background HIV-infected female sex workers (FSWs) have poor linkage to HIV care in sub-Sahara Africa. Methods We conducted 21 participatory group discussions (PGDs) to explore factors influencing linkage to HIV care among FSWs tested for HIV through a comprehensive community-based HIV prevention project in Tanzania. Results Influences on linkage to care were present at the system, societal and individual levels. System-level factors included unfriendly service delivery environment, including lengthy pre-enrolment sessions, concerns about confidentiality, stigmatising attitudes of health providers. Societal-level factors included myths and misconceptions about ART and stigma. On the individual level, most notable was fear of not being able to continue to have a livelihood if one’s status were to be known. Facilitators were noted, including the availability of transport to services, friendly health care providers and peer-support referral and networks. Conclusion Findings of this study underscore the importance of peer-supported linkages to HIV care and the need for respectful, high-quality care.