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Prevalence and structural correlates of HIV and STI testing among a community-based cohort of women sex workers in Vancouver Canada

BACKGROUND: In light of the stark inequities in HIV and sexually transmitted infections (STIs) experienced by women sex workers, empirical evidence is needed to inform accessible and sex worker-friendly models of voluntary, confidential and non-coercive HIV and STI testing. We evaluated the prevalen...

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Autores principales: Goldenberg, Shira M., Pearson, Jennie, Moreheart, Sarah, Nazaroff, Hannah, Krüsi, Andrea, Braschel, Melissa, Bingham, Brittany, Shannon, Kate
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062647/
https://www.ncbi.nlm.nih.gov/pubmed/36996154
http://dx.doi.org/10.1371/journal.pone.0283729
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author Goldenberg, Shira M.
Pearson, Jennie
Moreheart, Sarah
Nazaroff, Hannah
Krüsi, Andrea
Braschel, Melissa
Bingham, Brittany
Shannon, Kate
author_facet Goldenberg, Shira M.
Pearson, Jennie
Moreheart, Sarah
Nazaroff, Hannah
Krüsi, Andrea
Braschel, Melissa
Bingham, Brittany
Shannon, Kate
author_sort Goldenberg, Shira M.
collection PubMed
description BACKGROUND: In light of the stark inequities in HIV and sexually transmitted infections (STIs) experienced by women sex workers, empirical evidence is needed to inform accessible and sex worker-friendly models of voluntary, confidential and non-coercive HIV and STI testing. We evaluated the prevalence and structural correlates of HIV/STI testing in the last 6 months in a large, community-based cohort of women sex workers in Vancouver, Canada. METHODS: Data were drawn from an open community-based open cohort of women sex workers (January 2010-August 2021) working across diverse street, indoor, and online environments in Vancouver, Canada. Using questionnaire data collected by experiential (sex workers) and community-based staff, we measured prevalence and used bivariate and multivariable logistic regression to model correlates of recent HIV/STI testing at enrollment. RESULTS: Of 897 participants, 37.2% (n = 334) identified as Indigenous, 31.4% as Women of Color/Black (n = 282), and 31.3% (n = 281) as White. At enrollment, 45.5% (n = 408) reported HIV testing, 44.9% (n = 403) reported STI testing, 32.6% (n = 292) reported receiving both HIV and STI testing, and 57.9% (n = 519) had received an HIV and/or STI test in the last 6 months. In adjusted multivariable analysis, women accessing sex worker-led/specific services had higher odds of recent HIV/STI testing, (Adjusted Odds Ratio (AOR): 1.91, 95% Confidence Interval (CI): 1.33–2.75), whereas Women of Color and Black women (AOR: 0.52, 95%CI: 0.28–0.98) faced significantly lower odds of recent HIV/STI testing. CONCLUSIONS: Scaling-up community-based, sex worker-led and tailored services is recommended to enhance voluntary, confidential, and safe access to integrated HIV/STI testing, particularly for Women of Color and Black Women. Culturally safe, multilingual HIV/STI testing services and broader efforts to address systemic racism within and beyond the health system are needed to reduce inequities and promote safe engagement in services for racialized sex workers.
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spelling pubmed-100626472023-03-31 Prevalence and structural correlates of HIV and STI testing among a community-based cohort of women sex workers in Vancouver Canada Goldenberg, Shira M. Pearson, Jennie Moreheart, Sarah Nazaroff, Hannah Krüsi, Andrea Braschel, Melissa Bingham, Brittany Shannon, Kate PLoS One Research Article BACKGROUND: In light of the stark inequities in HIV and sexually transmitted infections (STIs) experienced by women sex workers, empirical evidence is needed to inform accessible and sex worker-friendly models of voluntary, confidential and non-coercive HIV and STI testing. We evaluated the prevalence and structural correlates of HIV/STI testing in the last 6 months in a large, community-based cohort of women sex workers in Vancouver, Canada. METHODS: Data were drawn from an open community-based open cohort of women sex workers (January 2010-August 2021) working across diverse street, indoor, and online environments in Vancouver, Canada. Using questionnaire data collected by experiential (sex workers) and community-based staff, we measured prevalence and used bivariate and multivariable logistic regression to model correlates of recent HIV/STI testing at enrollment. RESULTS: Of 897 participants, 37.2% (n = 334) identified as Indigenous, 31.4% as Women of Color/Black (n = 282), and 31.3% (n = 281) as White. At enrollment, 45.5% (n = 408) reported HIV testing, 44.9% (n = 403) reported STI testing, 32.6% (n = 292) reported receiving both HIV and STI testing, and 57.9% (n = 519) had received an HIV and/or STI test in the last 6 months. In adjusted multivariable analysis, women accessing sex worker-led/specific services had higher odds of recent HIV/STI testing, (Adjusted Odds Ratio (AOR): 1.91, 95% Confidence Interval (CI): 1.33–2.75), whereas Women of Color and Black women (AOR: 0.52, 95%CI: 0.28–0.98) faced significantly lower odds of recent HIV/STI testing. CONCLUSIONS: Scaling-up community-based, sex worker-led and tailored services is recommended to enhance voluntary, confidential, and safe access to integrated HIV/STI testing, particularly for Women of Color and Black Women. Culturally safe, multilingual HIV/STI testing services and broader efforts to address systemic racism within and beyond the health system are needed to reduce inequities and promote safe engagement in services for racialized sex workers. Public Library of Science 2023-03-30 /pmc/articles/PMC10062647/ /pubmed/36996154 http://dx.doi.org/10.1371/journal.pone.0283729 Text en © 2023 Goldenberg et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Goldenberg, Shira M.
Pearson, Jennie
Moreheart, Sarah
Nazaroff, Hannah
Krüsi, Andrea
Braschel, Melissa
Bingham, Brittany
Shannon, Kate
Prevalence and structural correlates of HIV and STI testing among a community-based cohort of women sex workers in Vancouver Canada
title Prevalence and structural correlates of HIV and STI testing among a community-based cohort of women sex workers in Vancouver Canada
title_full Prevalence and structural correlates of HIV and STI testing among a community-based cohort of women sex workers in Vancouver Canada
title_fullStr Prevalence and structural correlates of HIV and STI testing among a community-based cohort of women sex workers in Vancouver Canada
title_full_unstemmed Prevalence and structural correlates of HIV and STI testing among a community-based cohort of women sex workers in Vancouver Canada
title_short Prevalence and structural correlates of HIV and STI testing among a community-based cohort of women sex workers in Vancouver Canada
title_sort prevalence and structural correlates of hiv and sti testing among a community-based cohort of women sex workers in vancouver canada
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062647/
https://www.ncbi.nlm.nih.gov/pubmed/36996154
http://dx.doi.org/10.1371/journal.pone.0283729
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