Reproductive Health Care Utilization by Women Who Inject Drugs and Exchange Sex in the Seattle Area

Characterization of Patients Seeking Care at a Sexual Health Clinic Who Report Engaging in Exchange Sex

“…24 , 25 Women who inject drugs and exchange sex surveyed in the 2016 Seattle area NHBS survey reported receiving STI testing in private and community clinics more frequently than in sexual health clinics. 14 In contrast, a prior study in Colorado Springs estimated that 80% of all “female prostitutes” were seen in the health department STD clinic during 1970 to 1990. One factor that likely contributed to this was health department outreach efforts, including “recruiting efforts … where and when prostitutes work.” 26 Models of care, such as community clinics colocated with other services or peer-based clinics, may have more success engaging this population.…”

“…For many PWES, the use of primary health care is limited and to the extent they seek medical care, it is often in an emergency department setting. Among women who exchange sex and inject drugs surveyed in the 2016 Seattle area National HIV Behavioral Surveillance survey, 55% reported that they did not get the medical care they needed in the past year 14 . Common reasons for avoiding care include negative experiences in the health care system, need for walk-in services and evening or weekend hours, concerns about cost and transportation, as well lack of awareness of services 14–16 .…”

“…[14][15][16] When PWES do access health care, they often do not disclose to medical providers that they exchange sex. 9,[14][15][16] The literature is limited regarding effective models of care for engaging PWES in the US health care system. Two published examples include a peer-based multiservice clinic in San Francisco and a continuity clinic model colocated with a community-based organization that serves people living homeless in Seattle.…”

“…Among women who exchange sex and inject drugs surveyed in the 2016 Seattle area National HIV Behavioral Surveillance survey, 55% reported that they did not get the medical care they needed in the past year 14 . Common reasons for avoiding care include negative experiences in the health care system, need for walk-in services and evening or weekend hours, concerns about cost and transportation, as well lack of awareness of services 14–16 . When PWES do access health care, they often do not disclose to medical providers that they exchange sex 9,14–16 …”

“… 14 – 16 When PWES do access health care, they often do not disclose to medical providers that they exchange sex. 9 , 14 – 16 …”