title: Facilitators and Barriers to Linkage to HIV Care among Female Sex Workers Receiving HIV Testing Services at a Community-Based Organization in Periurban Uganda: A Qualitative Study.
abstract: Introduction. While four in ten female sex workers (FSWs) in sub-Saharan Africa are infected with HIV, only a small proportion is enrolled in HIV care. We explored facilitators and barriers to linkage to HIV care among FSWs receiving HIV testing services at a community-based organization in periurban Uganda. Methods. The cross-sectional qualitative study was conducted among 28 HIV positive FSWs from May to July 2014. Key informant interviews were conducted with five project staff and eleven peer educators. Data were collected on facilitators for and barriers to linkage to HIV care and manually analyzed following a thematic framework approach. Results. Facilitators for linkage to HIV care included the perceived good quality of health services with same-day results and immediate initiation of treatment, community peer support systems, individual's need to remain healthy, and having alternative sources of income. Linkage barriers included perceived stigma, fear to be seen at outreach HIV clinics, fear and myths about antiretroviral therapy, lack of time to attend clinic, and financial constraints. Conclusion. Linkage to HIV care among FSWs is influenced by good quality friendly services and peer support. HIV service delivery programs for FSWs should focus on enhancing these and dealing with barriers stemming from stigma and misinformation.
authors: MakSPH-CDC Fellowship Program, Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda; Reach Out Mbuya Parish HIV/AIDS Initiative, Kampala, Uganda.
authors: Sharon
authors: 0000-0003-0502-9147
authors: S
authors: Nakanwagi
authors: MakSPH-CDC Fellowship Program, Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda; Department of Community Health & Behavioral Sciences, Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda.
authors: Joseph K B
authors: 0000-0001-6480-2940
authors: JK
authors: Matovu
authors: Reach Out Mbuya Parish HIV/AIDS Initiative, Kampala, Uganda.
authors: Betty N
authors: BN
authors: Kintu
authors: Department of Community Health & Behavioral Sciences, Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda.
authors: Frank
authors: 0000-0001-7795-5540
authors: F
authors: Kaharuza
authors: MakSPH-CDC Fellowship Program, Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda; Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda.
authors: Rhoda K
authors: 0000-0001-5864-3314
authors: RK
authors: Wanyenze