Structural and Interpersonal Benefits and Risks of Participation in HIV Research: Perspectives of Female Sex Workers in Guatemala

Abstract

This study explored perceived benefits and risks of participation in HIV research among 33 female sex workers in Tecun Uman, Guatemala. Stigma associated with sex work and HIV was a critical barrier to research participation. Key benefits of participation included access to HIV/STI prevention and testing, as well as positive and trusting relationships between sex workers and research teams. Control exerted by managers had mixed influences on perceived research risks and benefits. Results underscore the critical need for HIV investigators to develop population-tailored procedures to reduce stigma, engage managers, and reinforce trusting, reciprocal relationships between sex work communities and researchers.

Exploring the Context and Implementation of Public Health Regulations Governing Sex Work: A Qualitative Study with Migrant Sex Workers in Guatemala

“…Participants' participation to this study was completely voluntarily and aimed to protect FSWs confidentiality and privacy [38]. It was informed to the participants that they could stop or terminate the session at any moment if they felt uncomfortable or tired [17].…”

“…This analysis included testimonies of 53 FSWs, of which 28 completed interviews as part of a study of migration and sex work [12] (November 2012-January 2014), which obtained information on sex work history, and interactions with authorities (Tecún Umán n = 15 and Quetzaltenango n = 13). We also analyzed the narratives of 25 migrant sex workers who completed interviews or focus groups as part of a study examining ethical issues related to sex workers' health and HIV research participation in Tecún Umán from June 2013 to February 2014) [17]; of these, n = 5 women completed interviews, whereas n = 20 participated in focus groups (n = 7 groups, each of which was comprised of 3-4 participants).…”

“…Interviews were appropriate for gaining insight into individual experiences and circumstances, and especially important for those who preferred to be interviewed privately; whereas focus groups were used to stimulate group discussion and collective insights [17,39].…”

“…Although limited information is available regarding the health impacts of sex work regulations and health practices in Central America [10,17], in some settings where similar policies exist (e.g., Tijuana, Mexico), FSWs report barriers to compliance with local sex work regulations (i.e., barriers to obtaining a health permit to engage in sex work) [18,19].…”

Enhancing the Responsible Conduct of Sexual Health Prevention Research Across Global and Local Contexts: Training for Evidence-Based Research Ethics

“…The first article in this issue by Goldenberg, Rivera-Mindt, Rocha Jimenez, Brouwer, Miranda, and Fisher (2015/this issue) explored perceived benefits and risks of participation in HIV research among female sex workers (FSWs) in Tecun Uman, Guatemala. FSWs remain disproportionately impacted by HIV and sexually transmitted infections (STIs; Baral et al, 2012) and continue to face substantial structural barriers to HIV prevention, treatment, and care based on stigmatization and criminalization of sex work activities (Shannon, Goldenberg, Deering, & Strathdee, 2014).…”