Dataset Information

Access to HIV-prevention in female sex workers in Ukraine between 2009 and 2017: Coverage, barriers and facilitators.

ABSTRACT: The provision of comprehensive prevention services is vital for reducing the high burden of HIV amongst Ukrainian female sex workers (FSWs). To identify barriers and facilitators that influence access to HIV prevention amongst this population between 2009 and 2017, we developed a literature-informed conceptual framework and conducted a document analysis to identify the components of the Ukrainian prevention package (PP). Using the Integrated Bio Behavioural Surveillance Surveys, we then conducted descriptive analyses to explore PP coverage from 2009 to 2017 and the influence of factors, identified by our conceptual framework. After increasing over four years, a drop in PP coverage was observed from 2013 onwards. Being a client of a non-governmental organisation, street and highway solicitation, non-condom use, and knowledge of HIV may influence access to HIV prevention in the Ukrainian context. Future interventions should consider barriers and facilitators to HIV prevention and the multiple structural levels on which they operate.

SUBMITTER: Blumer N

PROVIDER: S-EPMC8051789 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Access to HIV-prevention in female sex workers in Ukraine between 2009 and 2017: Coverage, barriers and facilitators.

Blumer Natasha N Pfadenhauer Lisa M LM Burns Jacob J

PloS one 20210416 4

The provision of comprehensive prevention services is vital for reducing the high burden of HIV amongst Ukrainian female sex workers (FSWs). To identify barriers and facilitators that influence access to HIV prevention amongst this population between 2009 and 2017, we developed a literature-informed conceptual framework and conducted a document analysis to identify the components of the Ukrainian prevention package (PP). Using the Integrated Bio Behavioural Surveillance Surveys, we then conducte ...[more]

PMID: 33861784

Similar Datasets

Project description:The sexual health of female sex workers is of particular concern due to severe complications arising from multiple and unprotected sexual relationships. This qualitative study, the initial study conducted in Iran, explored the sexual health needs, barriers, and facilitators to accessing sexual health services among women at high risk of STIs in Arak. In this qualitative research study, we used a content analysis design. Fourteen female sex workers who attended the specialized HIV center in Arak participated in the study. Data were collected and analyzed using qualitative content analysis. Data were classified into three main themes: (1) barriers and facilitators in accessing sexual health services; (2) educational needs for sexual health; and (3) peer education from the perspectives of sex workers. Three categories of barriers emerged: "personal", "environmental and structural", and "psychological and social" ones. Personal barriers included a lack of information, privacy concerns, fear of untreatable or complex diagnoses, and cultural beliefs and shame. Environmental and structural barriers included financial barriers, inadequate emphasis on sexual health, mistreatment by healthcare staff, poor quality of distributed condoms, and insufficient preventive education. Psychological and social barriers included partner rejection following infection. Facilitators for accessing sexual health services included respectful care, effective counseling for anxiety and stress. Access to preventive healthcare included the availability of screenings and vaccinations, and condom distribution at the center. Educational needs encompassed skills in negotiation and communication, understanding sexual health, positive body image and accepting sexual orientation, and preventing and managing STIs. The participants believed that peer education offers several benefits, including building credibility and trust among peers, fostering positive interactions within peer groups, enhancing support through shared experiences, improving access to educational resources and empowerment through peer education. However, it also presented drawbacks, such as a lack of trust in peers and deficiencies in specialized resources. To improve access to sexual health services for female sex workers, it is essential for services to be transparently and comprehensively introduced; and for cultural and social barriers to be reduced. Additionally, it is recommended that services be provided either free of charge or at reduced costs to enable this vulnerable group to utilize the services effectively. Future studies should focus on investigating strategies to gather data and improve sexual health of female sex workers at community level.

Project description:ObjectivesDiabetes is a growing global health concern. International guidelines recommend referral to diabetes prevention programmes (DPPs) for those at high risk of type 2 diabetes. However, many of those eligible to participate in DPPs are not referred. Healthcare workers (HCWs) are pivotal to the referral processes. This study aimed to identify, appraise and synthesise barriers and facilitators to referral to DPPs from the perspective of HCWs.DesignSystematic review using the best-fit framework synthesis.Data sourcesMEDLINE, Embase, CINAHL, PsychINFO, Web of Science and Scopus were searched from January 1997 to July 2023.Eligibility criteriaQualitative, quantitative and mixed methods primary studies exploring HCWs' perspectives of barriers and facilitators to referral to DPPs.Data extraction and synthesisOne author screened, extracted and appraised the literature while a second author independently verified at least a 20% sample at each stage. Quality was assessed using the Mixed Methods Appraisal Tool. The best-fit framework approach was used to synthesise the evidence with the Theoretical Domains Framework as the a priori framework.ResultsOf 9998 studies identified, 31 met the inclusion criteria, with a further six identified from reference and citation searching. Barriers and facilitators were coded to 11 of the 14 TDF domains and to another category 'Expectation of Patient Barriers'. The most frequently occurring domains for both barriers and facilitators were Environmental Context and Resources, Expectation of Patient Barriers and Knowledge. HCWs felt that clear easy referral pathways to the programmes and additional staff or resources were essential to improve referral. HCWs' were concerned that attending the DPP would place a (time and/or financial) burden on their patients which left them conflicted about referral. HCWs lacked knowledge of the effectiveness, availability and accessibility of DPPs.ConclusionsFuture strategies to improve referral to DPPs should include clear referral pathways and the resourcing of referral. Strategies are also needed to build awareness of DPPs and to address concerns among HCWs about their patients.

Project description:We know that suicide is preventable, yet hundreds of thousands of people still die due to suicide every year. Many interventions were proven to be effective, and dozens of others showed promising results. However, translating these interventions into new settings brings several challenges. One of the crucial obstacles to success is not anticipating possible barriers to implementation nor enhancing possible benefits of factors facilitating the implementation. While we witnessed great support for suicide prevention activities globally in the past years, implementation barriers and facilitating factors are yet to be comprehensively mapped to help implementation activities worldwide. This scoping review maps current knowledge on facilitators and barriers to the implementation of suicide prevention interventions while using the Consolidated Framework for Implementation Research (CFIR) for classification. We included 64 studies. Barriers and facilitators were most commonly identified in the outer setting CFIR domain, namely in the sub-domain of patient needs and resources, which refers to the way in which these needs and resources are reflected by the reviewed interventions. The second most saturated CFIR domain for facilitators was intervention characteristics, where relative advantage, adaptability and cost of intervention sub-domains were equally represented. These sub-domains refer mostly to how the intervention is perceived by key stakeholders, to what extent it can be tailored to the implementation context and how much it costs. While intervention characteristics domain was the second most common also for barriers, the complexity sub-domain referring to high perceived difficulty of implementation was the most frequently represented. With reference to the results, we recommend adapting interventions to the needs of the target groups. Furthermore, carefully selecting the intervention to suit the target context concerning their adaptability, costs and complexity is vital for a successful implementation. Further implications for practice and research are discussed.

Project description:BackgroundLong-acting injectable antiretrovirals (LAI-ARVs) for HIV prevention and treatment have been demonstrated in clinical trials to be non-inferior to daily oral medications, providing an additional option to help users overcome the challenges of daily adherence. Approval and implementation of these regimens in low- and middle-income settings have been limited.MethodThis study describes the anticipated barriers and facilitators to implementing LAI-ARVs in Vietnam to inform future roll-out. From July to August 2022, we conducted 27 in-depth interviews with healthcare workers and public health stakeholders involved in HIV programs at national, provincial, and clinic levels across four provinces in Vietnam. The interviews followed a semi-structured questionnaire and were audio recorded. Data were analyzed using a rapid thematic analysis approach to identify facilitators and barriers to the adoption of LAI-ARVs.ResultsIn total, 27 participants from 4 provinces were interviewed including 14 (52%) men and 13 (48%) women. Participants median age was 48 years and they had 11.5 years of experience with HIV services and programs. Perceived user-level facilitators included the greater convenience of injectables in comparison to oral regimens, while barriers included the increased frequency of visits, fear of pain and side effects, and cost. Clinic-level facilitators included existing technical capacity to administer injections and physical storage availability in district health centers, while barriers included lack of space and equipment for administering injections for HIV-related services, concerns about cold chain maintenance for LAI-ART, and workload for healthcare workers. Health system-level facilitators included existing mechanisms for medication distribution, while barriers included regulatory approval processes and concerns about supply chain continuity.ConclusionOverall, participants were optimistic about the potential impact of LAI-ARVs but highlighted important considerations at multiple levels needed to ensure successful implementation in Vietnam.Clinical trial numberNot applicable.

Dataset Information

Access to HIV-prevention in female sex workers in Ukraine between 2009 and 2017: Coverage, barriers and facilitators.

Publications

Access to HIV-prevention in female sex workers in Ukraine between 2009 and 2017: Coverage, barriers and facilitators.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets