title: Structural barriers to receiving health care services for female sex workers in Russia.
abstract: Female sex workers in Russia have been particularly vulnerable to recent social, political, and economic changes. In this article, we describe the facilitators and barriers for sex workers receiving health care services in St. Petersburg, Russia. We conducted observations at medical institutions and nongovernmental organizations and in-depth interviews with 29 female sex workers. We identified the following barriers: poverty, not having documents, lack of anonymity in testing, and the official registration system. We identified the following facilitators: intervention by family members, social connections within the health care system, and referral services from a nongovernmental organization. Our findings indicate a need for reassessing policies and designing programs that better facilitate the use of health care services for the most vulnerable populations. This should include the expansion of support systems and outreach services designed to help female sex workers navigate the health care system.
authors.affiliation: Yale School of Public Health, New Haven, Connecticut, USA. zabeth.king@aya.yale.edu
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: King
authors.forename: Suzanne
authors.initials: S
authors.lastname: Maman
mesh_terms: D022126:Access to Information; D000328:Adult; D015897:Comorbidity; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D007407:Interviews as Topic; D019370:Observation; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D036301:Qualitative Research; D012042:Registries; D012426:Russia / Q000453:epidemiology; D060386:Sex Workers / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000191:economics / Q000453:epidemiology; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology; D014478:Unemployment; D055815:Young Adult
keywords: Europe, Eastern; HIV/AIDS; health care, access to; sex workers