title: Barriers to health service access among female migrant Ugandan sex workers in Guangzhou, China.
abstract: Increased trade between China and Uganda has fueled trafficking of female Ugandans into China. These women may face challenges accessing health services. This study focused on examining barriers to health care access among female Ugandan sex workers in China.
  
  
  
  In 2014, we undertook in-depth interviews with 19 female Ugandan sex workers in Guangzhou, China. Interviews focused on barriers to health service access and were analyzed using an a priori coding framework followed by open-coding to capture emergent themes.
  
  
  
  Out of 19 women, 12 women reported a history of being trafficked into China. None of the women had a valid Chinese visa. Fear of being arrested for lack of documentation discouraged women in this sample from accessing hospital services. Low pay, housing exploitation, and remittances contributed to participants' lack of financial resources, which further inhibited their ability to access health services. Participants expressed feeling social isolation from the local community and reported mistrust of local individuals and organizations, including hospitals.
  
  
  
  Ugandan sex workers in China faced substantial structural barriers that limited health service access. Policy changes and the development of new programs are urgently needed to ensure these women have improved access to health services.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality & Health, Columbia University and the New York State Psychiatric Institute, 1051 Riverside Dr, Unit 15, New York, NY, 10032, USA.|UNC-Project China, 2 Lujing Road, Guangzhou, China.
authors.forename: Alissa
authors.initials: A
authors.lastname: Davis
authors.affiliation: Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 1025 E 7th St. Rm PH116, Bloomington, IN, 47405, USA.|Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, Bloomington, USA.
authors.forename: Beth E
authors.initials: BE
authors.lastname: Meyerson
authors.affiliation: School of Medicine, University of North Carolina-Chapel Hill, 321 S Columbia Street, Chapel Hill, NC, 27516, USA.
authors.forename: Blessing
authors.initials: B
authors.lastname: Aghaulor
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California-San Francisco, 505 Parnassus Avenue, Rm. 1483, San Francisco, CA, 94143, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Brown
authors.affiliation: UNC-Project China, 2 Lujing Road, Guangzhou, China.
authors.forename: Adisyn
authors.initials: A
authors.lastname: Watson
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 306 Rosenau, Campus Box 7440, Chapel Hill, NC, 27599, USA.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Muessig
authors.affiliation: Guangdong Provincial STD Control Center, 2 Lujing Road, 11th Floor, Guangzhou, 510095, China.
authors.forename: Ligang
authors.initials: L
authors.lastname: Yang
authors.affiliation: UNC-Project China, 2 Lujing Road, Guangzhou, China. jdtucker@med.unc.edu.|School of Medicine, University of North Carolina-Chapel Hill, 321 S Columbia Street, Chapel Hill, NC, 27516, USA. jdtucker@med.unc.edu.|Guangdong Provincial STD Control Center, 2 Lujing Road, 11th Floor, Guangzhou, 510095, China. jdtucker@med.unc.edu.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D060386:Sex Workers / Q000523:psychology*; D012959:Socioeconomic Factors; D014171:Transients and Migrants / Q000523:psychology*; D014454:Uganda / Q000208:ethnology
keywords: China; Female sex workers; Health care access; Migrants; Uganda