Stigma as a Barrier to Mental Health Service Use Among Female Sex Workers in Switzerland

Zehnder, Mara; Mutschler, Jochen; Rössler, Wulf; Rufer, Michael; Rüsch, Nicolas

doi:10.3389/fpsyt.2019.00032

Cited by 27 publications

(28 citation statements)

References 11 publications

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“…Consistent with previous studies, sex work stigma was associated with high levels of PTSD and depressive symptoms (Carlson et al, 2017;Stockton et al, 2020;Zehnder et al, 2019). Given that stigma deters individuals from seeking care (Gulliver et al, 2010;Nyblade et al, 2017;Rayson & Alba, 2019;Scorgie et al, 2013;Zehnder et al, 2019) and adhering to treatment protocols (Denison et al, 2015;Dow et al, 2016;Koole et al, 2016), this finding points to the need to integrate stigma-reduction components in HIV programming targeting WESW to address mental health functioning.…”

Section: Discussionsupporting

confidence: 85%

Predictors of Depressive Symptoms and Post Traumatic Stress Disorder Among Women Engaged in Commercial Sex Work in Southern Uganda

Nabunya

Byansi

Damulira

et al. 2021

Psychiatry Research

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This study examined the factors associated with depressive symptoms and post traumatic depressive disorder (PTSD) among economically vulnerable women engaged in commercial sex work (WESW) in southern Uganda. Baseline data from a longitudinal cluster randomized study involving 542 self-identified WESW (18-55 years), recruited from 19 HIV hotspots were analyzed. Hierarchical linear regression modelling was utilized to estimate individual, family-level and economic-level predictors of depressive symptoms and PTSD. Family cohesion, sex work stigma, HIV status, financial distress, household assets, number of children and number of household income earners, were associated with PTSD. Similarly, family cohesion, number of people in the household, HIV status, sex work stigma, financial distress, and household assets, were associated with depressive symptoms. Women engaged in commercial sex work are at a higher risk of HIV and poor mental health outcomes. Sex work stigma and financial distress elevate levels of depressive symptoms and PTSD, over and above an individual's HIV status. Family and economic-level factors have the potential to mitigate the risk of poor mental health outcomes. As such, integrating stigma reduction and economic strengthening components in the programming targeting WESW-a key population, may be critical to address their mental health outcomes.

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Section: Discussionsupporting

confidence: 85%

Predictors of Depressive Symptoms and Post Traumatic Stress Disorder Among Women Engaged in Commercial Sex Work in Southern Uganda

Nabunya

Byansi

Damulira

et al. 2021

Psychiatry Research

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“…Attitudinal barriers allude to ideas about the treatment of mental disorders; the instrumental refers to logistical difficulties, such as financial, insurance model, benefit or coverage plans, service, administrative and institutional networks, and those associated with stigma-discrimination cover prejudices and stereotypes for mental disorders. Other authors have grouped the barriers proposed by Clement et al (2012) into two categories in related and not related to stigma-discrimination; in this last category, they locate attitudinal and instrumental barriers (Dockery et al, 2015; Hayward & Honegger, 2018; Oexle et al, 2015; Wigand et al, 2019; Zehnder et al, 2019). Campo-Arias et al (2014) considered that instrumental barriers are institutional barriers.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have used BACE to assess barriers to accessing mental health care in patients in the psychiatric clinic. However, only the response pattern for each item reported in those studies (Dockery et al, 2019, Ferlatte et al, 2019Hayward & Honegger, 2018;James et al, 2019;Luitel et al, 2017;Oexle et al, 2015;Salaheddin & Mason, 2016;Wigand et al, 2019;Zehnder et al, 2019). This quantification technique represents a significant problem since the reliability and reproducibility of the measurement is low for constructs with three items or less (Emons et al, 2007) and reaches the worst estimate for individual items (Paunonen, 1984).…”

Section: Introductionmentioning

confidence: 99%

Barriers to access to mental health services among Colombia outpatients

Campo‐Arias

Ospino

Herazo³

2020

Int J Soc Psychiatry

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Background: Access barriers are all situations or conditions that limit seeking, receiving or enjoying benefits offered by the health system. This set of situations translates into underutilization of the services offered. In Colombia, there is little information about barriers to accessing medical care in general, and even less in the specific field of mental health. Aim: To determine the barriers to accessing psychiatric care in outpatients in Santa Marta, Colombia. Methods: The authors designed a cross-sectional study with a non-probability sample of adult patients who consulted between August and December 2018. The barriers to access were measured with a 20-item version of the Barriers to Access to Care Evaluation (BACE) scale. Results: A total of 247 patients participated; they were between 18 and 82 years (mean ( M) = 47.5, standard deviation ( SD) = 13.9). A total of 69 (27.9%) patients classified as having major attitudinal barriers; 62 (25.1%) patients, major barriers related to stigma-discrimination; and 41 (16.6%) patients, major instrumental barriers. Concerning the associated variables, age less than 45 years was related to major attitudinal barriers (odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.6-5.5), major barriers related to stigma-discrimination (OR = 3.8, 95% CI 2.0-7.2) and major instrumental barriers (OR = 2.7, 95% CI 1.3-5.3). Men reported major instrumental barriers more frequently than women (OR = 2.8, 95% CI 1.3-5.8). Conclusion: The major attitudinal, related to stigma-discrimination and instrumental barriers to access frequently delay a consultation with mental health services. Actions are necessary to reduce barriers to accessing mental health care.

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“…A dearth of literature draws on radical feminist discourse regarding sex workers, their agency, and the subsequent power dynamics with clients (Gerassi, 2015). Abolitionist or prohibitionist theories view sex work as exploitative, derived from the understanding that society sits on patriarchal foundations (Comte, 2014), leading to violence, drug use, poor health and deprivation (de Graaf et al, 1994;Kinnell, 2008;Sanders et al, 2009;Shokoohi et al, 2019;Zehnder et al, 2019).…”

Section: Agency and Power In The Relationshipmentioning

confidence: 99%

Sex tourism in an era of globalisation, harm reduction and disease migration: a new conceptual model

Hillis

Leavey

Kewley

et al. 2021

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Purpose This paper aims to contribute to sex tourism literature by placing it into a contemporary context of globalisation, harm reduction and disease migration. Design/methodology/approach The paper takes a public health and social science approach to map sex tourism, drawing on sex worker and tourist situations alongside global forces including technology, human rights, law enforcement and health. Findings A new, holistic conceptual model is presented, containing interacting, multi level associations. Whilst the separate micro, contextual, meso and macro levels are versatile, decision makers and practitioners will be equipped to understand sex tourism in its entirety. Originality/value The paper’s originality is found in the proposed conceptual model.

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Stigma as a Barrier to Mental Health Service Use Among Female Sex Workers in Switzerland

Cited by 27 publications

References 11 publications

Predictors of Depressive Symptoms and Post Traumatic Stress Disorder Among Women Engaged in Commercial Sex Work in Southern Uganda

Predictors of Depressive Symptoms and Post Traumatic Stress Disorder Among Women Engaged in Commercial Sex Work in Southern Uganda

Barriers to access to mental health services among Colombia outpatients

Sex tourism in an era of globalisation, harm reduction and disease migration: a new conceptual model

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