Motivators and barriers to HIV testing among street-based female sex workers in St. Petersburg, Russia

Abstract

Female sex workers are particularly susceptible to HIV infection in Russia. However, a dearth of information exists on their utilization of HIV services. A mixed-methods, cross-sectional study was conducted to examine motivators and barriers to HIV testing among street-based sex workers in St. Petersburg, Russia. The Health Belief Model was the theoretical framework for the study. Twenty-nine sex workers participated in in-depth interviews, and 139 sex workers completed interviewer-administered surveys between February and September 2009. Barriers to getting an HIV test were fear of learning the results, worrying that other people would think they were sick, and the distance needed to travel to obtain services. Motivators for getting tested were protecting others from infection, wanting to know one’s status and getting treatment if diagnosed. Logistic regression analysis demonstrated that knowing people living with HIV [aOR=6.75, 95% CI (1.11, 41.10)] and length of time since start of injection drug use [aOR=0.30, 95% CI (0.09, 0.97)] are significantly associated with recently getting tested. These results are important to consider when developing public health interventions to help female sex workers in Russia learn their HIV status and get linked to care and treatment services if needed.

HIV Testing and Counseling Among Female Sex Workers: A Systematic Literature Review

“…About half of the articles reviewed assessed how FSWs’ social interactions influenced their decision to test for HIV [18–20, 24, 26, 29, 34, 38, 40, 41, 43, 45, 47–51]. Positive attitudes and support from peers, family and partners facilitated HIV testing [19, 20, 24, 26, 29, 34, 40, 41, 45, 48–51].…”

“…Positive attitudes and support from peers, family and partners facilitated HIV testing [19, 20, 24, 26, 29, 34, 40, 41, 45, 48–51]. In China, women were more likely to test if accompanied by peers [19, 20].…”

“…A total of fourteen articles focused on stigma and discrimination of HIV+ people and/or sex workers [20, 24, 26, 29, 31, 34, 36, 41, 46–52]. Fears of being identified as HIV+ [24, 26, 31, 34, 36, 41, 47–51] or as a sex worker [20, 26, 31, 34, 41, 46–52] were reported as barriers to testing in a number of studies.…”

“…Fears of being identified as HIV+ [24, 26, 31, 34, 36, 41, 47–51] or as a sex worker [20, 26, 31, 34, 41, 46–52] were reported as barriers to testing in a number of studies. FSWs could refuse HIV testing [29, 36, 41, 48, 50, 52] or fail to collect test results [48] if afraid of receiving an HIV+ diagnosis.…”

“…Sex work criminalization in Kenya, Zimbabwe, Uganda and South Africa, Canada, Uzbekistan and Russia [24, 25, 27, 32, 51, 52, 54] and fear of registration as a drug-user in Russia [24, 34] are seen to have hampered access to healthcare, including testing.…”