Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Barriers to Health Service Utilization Among Iranian Female Sex Workers: A Qualitative Study

  • Asadi-AliAbadi, Mehran (Department of Epidemiology, School of Public Health, Iran University of Medical Sciences) ;
  • Abolghasemi, Jamileh (Department of Biostatistics, School of Public Health, Iran University of Medical Sciences) ;
  • Rimaz, Shahnaz (Department of Epidemiology, School of Public Health, Iran University of Medical Sciences) ;
  • Majdzadeh, Reza (Community Based Participatory Research Center and Knowledge Utilization Research Center, Tehran University of Medical Sciences) ;
  • Rostami-Maskopaee, Fereshteh (Department of Public Health, School of Public Health, Mazandaran University of Medical Sciences) ;
  • Merghati-Khoei, Effat (Iranian Center of Addiction Studies (INCAS), Tehran University of Medical Sciences)
  • Received : 2017.10.30
  • Accepted : 2018.01.06
  • Published : 2018.03.31
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Abstract

Objectives: In most countries around the world, sex work is an illegal activity. Female sex workers (FSWs) in Iran hide their identities, and they are known to be a hard-to-reach population. Despite free access to HIV testing, fewer than half of FSWs receive HIV testing. The purpose of this study was to characterize the reasons for which FSWs do not seek testing at drop-in centers (DICs) and voluntary counseling and testing (VCT) centers in Iran. Methods: A qualitative study was conducted in 2016. The participants were 24 FSWs who received services at VCT centers and DICs for vulnerable females in the north of Iran and 9 males who were the clients of FSWs. In this study, we made use of purposive sampling and carried out a thematic analysis. Results: We found 4 major and 6 minor themes. The major themes were: fear of being infected (with HIV), stigma, indifference, and knowledge. Conclusions: Despite the significant efforts made by the government of Iran to establish and expand DICs for vulnerable females, the number of FSWs receiving services at these centers has not been very considerable. Consequently, by introducing and implementing training programs for peer groups, it may be possible to take steps toward establishing strategic programs for the control and prevention of HIV/AIDS.

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