Health services utilisation for sexually transmitted infections including HIV by female sex workers in Nepal

• Main Author: Ghimire, Laxmi
• Published: University of Aberdeen 2010
• Subjects: 610.7343; Prostitution : Prostitutes : Sex-oriented businesses : HIV Infections : Sexually transmitted diseases
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.531861

A total of 425 questionnaire-based interviews and 15 in-depth interviews with FSWs in Nepal including non-participant observation in the field were conducted in 2006. The age range of the FSWs participated was 15-46 years.  FSWs (30.8%) reported having had STI symptoms in presences 12 month.  The quantitative findings suggested that many reported having used condoms during their last sexual intercourse, but in-depth interviews suggested the opposite.  One fifth (21%) had never visited health facilities.  Of those who visited, 149 (50.3%) turned to a private clinic and pharmacy; 181 (61.1%) used Non-Governmental Organisation (NGO) clinics, 79 (26.6%) resorted to care in hospital and 30 (10.1%) treated themselves.  The remainder 85 (28.7%) were found to seek help from primary health care centre, health posts, family planning clinic or other health institutions for treatment.  The behaviour theories and models used in this study (i.e. health belief model, theory of reasoned action and planned behaviour) partly explain the decisions of FSW on use and non-use of available health services.  The study identified that lack of confidentiality and privacy created distrust among FSWs and stopped them from accessing health services.  Embarrassment, disregard by health care providers and poor communication with them, long waiting time and fear of exposure as a sex worker were major barriers to seeking health services. It is therefore necessary to provide specific training to service providers in all types of health care institutions in order to promote confidential and quality health services.