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Title Effect of a 'diagonal' intervention on uptake of HIV and reproductive health services by female sex workers in three sub-Saharan African cities
Full text https://biblio.ugent.be/publication/8570727; http://hdl.handle.net/1854/LU-8570727; http://dx.doi.org/10.1111/tmi.13072; https://biblio.ugent.be/publication/8570727/file/8570729
Date 2018
Author(s) Lafort, Yves; Greener, Letitia; Lessitala, Faustino; Chabeda, Sophie; Greener, Ross; Beksinska, Mags; Gichangi, Peter; Griffin, Sally; Smit, Jenni A; Chersich, Matthew; Delva, Wim
Abstract Objectives: To enhance uptake of sexual and reproductive health (SRH) services by female sex workers (FSWs), we conducted an implementation study in which we piloted and tested context-specific diagonal' interventions, combining vertical, targeted interventions with horizontally improved access to the general health services, in three cities in sub-Saharan Africa. Methods: We collected indicators of SRH service uptake through face-to-face interviews with approximately 400 FSWs, pre- and post-intervention, in Durban, South Africa; Tete, Mozambique; and Mombasa, Kenya, recruited by respondent-driven sampling. Changes in uptake were tested for their statistical significance using multivariate logistic regression models. Results: In all cities, overall uptake of services increased. Having used all services for contraception, STI care, HIV testing, HIV care, cervical cancer screening and sexual violence, if needed, increased from 12.5% to 41.5% in Durban, 25.0% to 40.1% in Tete and 44.9% to 69.1% in Mombasa. Across cities, the effect was greatest in having been tested for HIV in the past six months which increased from 40.9% to 83.2% in Durban, 56.0% to 76.6% in Tete and 70.9% to 87.6% in Mombasa. In Tete and Mombasa, rise in SRH service use was almost entirely due to a greater uptake of targeted services. Only in Durban was there additionally an increase in the utilisation of general health services. Conclusion: SRH service utilisation improved in the short-term in three different sub-Saharan African contexts, primarily through vertical, targeted components. The long-term effectiveness of diagonal approaches, in particular on the use of general, horizontal health services, needs further investigation.
Subject(s) Medicine and Health Sciences; SOUTH-AFRICA; COTE-DIVOIRE; CARE; POPULATIONS; BURDEN; ACCESS; KENYA; INDIA; MOZAMBIQUE; NAVIGATION; female sex workers; sexual and reproductive health; HIV prevention and; care; care-seeking behaviour; sub-Saharan Africa
Language eng
Type of publication journalArticle; info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion
Format application/pdf
Source TROPICAL MEDICINE & INTERNATIONAL HEALTH; ISSN: 1360-2276; ISSN: 1365-3156
Rights I have transferred the copyright for this publication to the publisher; info:eu-repo/semantics/restrictedAccess
Repository Gent - University of Gent
Added to C-A: 2020-11-12;11:20:14