title: Uptake of a women-only, sex-work-specific drop-in center and links with sexual and reproductive health care for sex workers.
abstract: OBJECTIVE
  To longitudinally examine female sex workers' (FSWs') uptake of a women-only, sex-work-specific drop-in service and its impact on their access to sexual and reproductive health (SRH) services.
  
  
  METHODS
  For the present longitudinal analysis, data were drawn from the AESHA (An Evaluation of Sex Workers' Health Access) study, a community-based, open, prospective cohort of FSWs from Vancouver, BC, Canada. Data obtained between January 2010 and February 2013 were analyzed. Participants are followed up on a semi-annual basis. Multivariable logistic regression using generalized estimating equations was used to identify correlates of service uptake.
  
  
  RESULTS
  Of 547 FSWs included in the present analysis, 330 (60.3%) utilized the services during the 3-year study period. Service use was independently associated with age (adjusted odds ratio [AOR] 1.04; 95% confidence interval [CI] 1.03-1.06), Aboriginal ancestry (AOR 2.18; 95% CI 1.61-2.95), injection drug use (AOR 1.67; 95% CI 1.29-2.17), exchange of sex for drugs (AOR 1.40; 95%CI 1.15-1.71), and accessing SRH services (AOR 1.65; 95% CI 1.35-2.02).
  
  
  CONCLUSIONS
  A sex-work-specific drop-in space for marginalized FSWs had high uptake. Women-centered and low-threshold drop-in services can effectively link marginalized women with SRH services.
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors: Soyoun Rachel
authors: SR
authors: Kim
authors: Gender and Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada.
authors: Shira M
authors: SM
authors: Goldenberg
authors: Gender and Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.
authors: Putu
authors: P
authors: Duff
authors: Gender and Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.
authors: Paul
authors: P
authors: Nguyen
authors: WISH Drop-In Centre Society, Vancouver, BC, Canada.
authors: Kate
authors: K
authors: Gibson
authors: Gender and Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada. Electronic address: gshi@cfenet.ubc.ca.
authors: Kate
authors: K
authors: Shannon
mesh_terms: D000328:Adult; D001955:British Columbia; D015331:Cohort Studies; D003153:Community Health Services / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D011446:Prospective Studies; D060728:Reproductive Health; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D060386:Sex Workers / Q000706:statistics & numerical data*; D062487:Social Marginalization
keywords: Health access; Health services; Outreach services; Peer-led; Reproductive health; Sex work; Sexual health; Support services
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