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The Influence of Stigma and Discrimination on Female Sex Workers’ Access to HIV Services in St. Petersburg, Russia

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Abstract

Stigma associated with HIV and risk behaviors is known to be a barrier to health care access for many populations. Less is known about female sex workers (FSW) in Russia, a population that is especially vulnerable to HIV-infection, and yet hard-to-reach for service providers. We administered a questionnaire to 139 FSW to better understand how stigma and discrimination influence HIV service utilization. Logistic regression analysis indicated that HIV-related stigma is negatively associated with uptake of HIV testing, while sex work-related stigma is positively associated with HIV testing. HIV-positive FSW are more likely than HIV-negative FSW to experience discrimination in health care settings. While decreasing societal stigma should be a long-term goal, programs that foster inclusion of marginalized populations in Russian health care settings are urgently needed.

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References

  1. World Health Organization (WHO). Violence against sex workers and HIV prevention. Violence against women and HIV/AIDS. Crit Intersections Inf Bull Ser, No. 3; 2005. http://www.who.int/gender/documents/sexworkers.pdf. Accessed 28 Feb 2012.

  2. Onishchenko GG. Epidemiologicheskaia situatsiia, osnovnye prioritety i zadachi po protivodeistviiu epidemii VICh/SPIDa v Rossiiskoi Federatsii. Zdravookhranenie RF. 2005;2:11–8.

    Google Scholar 

  3. Rakhmanova A. Sovmestnye initsiativy i effektivnoe partnerstvo AIDS Journal: SPID, Seks, Zdorov’e 64, 2007. http://www.aidsjournal.ru/journal/64_1.html. Accessed 28 Feb 2012.

  4. Federal AIDS Center of the Russian Federation. The number of HIV-infected people in Russia in 2010. 2010. http://www.hivrussia.org/stat/2010.shtml. Accessed 28 Feb 2012.

  5. Volkova GV, Davydov AA, Ivanova AB. VICh infektsiia v Sankt-Peterburge v 2005 godu. 2006. http://www.gov.spb.ru/helper/zdrav/gmu/aidscenter/spb_aids. Accessed 28 Feb 2012.

  6. UNAIDS. Russian Federation: country situation 2009. http://www.unaids.org/ctrysa/EURRUS_en.pdf. Accessed 28 Feb 2012.

  7. UNAIDS. Eastern Europe and Central Asia. AIDS Epidemic Update December 2005. 2005; 45–52.

  8. Niccolai LM, Toussova OV, Verevochkin SV, Barbour R, Heimer R, Kozlov AP. High HIV prevalence, suboptimal HIV testing, and low knowledge of HIV-positive serostatus among injection drug users in St. Petersburg, Russia. AIDS Behav. 2010;14(4):932–41.

    Article  PubMed  Google Scholar 

  9. Niccolai LM, Verevochkin SV, Toussova OV, White E, Barbour R, Kozlov AP, Heimer R. Estimates of HIV incidence among drug users in St. Petersburg, Russia: continued growth of a rapidly expanding epidemic. Eur J Pub Health. 2011;21(5):613–9.

    Article  Google Scholar 

  10. Sokolovskii EV, et al. Strategiia okazaniia venerologicheskoi pomoshchi narkozavisimym trebuet sovershenstvovaniia. Russkii zhurnal “SPID, rak, i obshchestvennoe zdorov’e”. 2005;9(1 ):6–7.

    Google Scholar 

  11. UNAIDS, UNFPA, UNIFEM. Women and HIV/AIDS: confronting the crisis. 2004. http://www.unfpa.org/upload/lib_pub_file/308_filename_women_aids1.pdf. Accessed 28 Feb 2012.

  12. Yakovleva T. Epidemiia VICh/SPIDa v Rossii: tsifri i fakty. Napravleniia borby s VICh-infektsiei i gosudarstvennye programmy profilaktiki. AIDS Journal SPID, Seks, Zdorov’e. 66. 2008. http://www.aidsjournal.ru/journal/66_13.html. Accessed 28 Feb 2012.

  13. Benotsch EG, Somlai AM, Pinkerton SD, et al. Drug use and sexual risk behaviours among female Russian IDU who exchange sex for drugs and money International. J STD AIDS. 2004;15(5):343–7.

    Article  CAS  Google Scholar 

  14. Kozlov A, Shaboltas AV, Toussova OV, et al. HIV incidence and factors associated with HIV acquisition among injection drug users in St. Petersburg. Russia AIDS. 2006;20(6):901–6.

    Article  Google Scholar 

  15. World Health Organization. HIV-related sentinel surveillance among risky populations in the Republic of Azerbaijan, Republic of Moldova and the Russian Federation, 2004. http://aids.md/aids/files/652/4fc6203a54516_hiv-sentinel-surveillance-high-risk-groups-aze-rm-rf.pdf. Accessed 28 Feb 2012.

  16. Niccolai LM, Odinokova VA, Safiullina LZ, Bodanovskaya ZD, Heimer R, Levina OS, Rusakova MM. Clients of street-based female sex workers and potential bridging of HIV/STI in Russia: results of a pilot study. AIDS Care. 2012;24(5):665–72.

    Article  PubMed  Google Scholar 

  17. Rhodes T, Lowndes C, Judd A, et al. Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City. Russ AIDS. 2002;6(13):F25–31.

    Article  Google Scholar 

  18. Grau LE, White E, Niccolai LM, et al. HIV disclosure, condom use, and awareness of HIV infection among HIV-positive, heterosexual drug injectors in St. Petersburg, Russian Federation. AIDS Behav. 2011;15(1):45–57.

    Article  PubMed  Google Scholar 

  19. Link BG, Phelan JC. Stigma and its public health implications. Lancet. 2006;367(9509):528–9.

    Article  PubMed  Google Scholar 

  20. Balabanova Y, Coker R, Atun RA, Drobniewski F. Stigma and HIV infection in Russia. AIDS Care. 2006;18(7):846–52.

    Article  PubMed  CAS  Google Scholar 

  21. UNDP. Living with HIV in Eastern Europe and the CIS: the human cost of social exclusion. 2008. http://hdr.undp.org/en/reports/regional/europethecis/EU_CIS_nhdr_aids_2008.pdf. Accessed 3 Sept 2012.

  22. Amirkhanian YA, Kelly JA, Kuznetsova AV, DiFranceisco WJ, Musatov VB, Pirogov DG. People with HIV in HAART-era Russia: transmission risk behavior prevalence, antiretroviral medication-taking, and psychosocial distress. AIDS Behav. 2011;15(4):767–77.

    Article  PubMed  Google Scholar 

  23. Orekhovsky V, Calzavar L, Yakovlev A, et al. Fuelling HIV epidemic in Russia: the stigma of IDU and HIV and its impact on treatment access and testing. Int Conf AIDS: abstract no. ThPpE2153; 2002.

  24. Genberg BL, Hlavka Z, Konda KA, et al. A comparison of HIV/AIDS-related stigma in four countries: negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS. Soc Sci Med. 2009;68(12):2279–87.

    Article  PubMed  Google Scholar 

  25. Shannon K, Bright V, Gibson K, Tyndall MW, Maka Project Partnership. Sexual and drug-related vulnerabilities for HIV infection among women engaged in survival sex work in Vancouver, Canada. Can J Public Health. 2007;98(6):465–9.

    PubMed  Google Scholar 

  26. Gollub EL. A neglected population: drug-using women and women’s methods of HIV/STI prevention. AIDS Educ Prev. 2008;20(2):107–20.

    Article  PubMed  Google Scholar 

  27. Liu SH, Srikrishnan AK, Zelaya CE, Solomon S, Celentano DD, Sherman SG. Measuring perceived stigma in female sex workers in Chennai, India. AIDS Care. 2011;23(5):619–27.

    Article  PubMed  Google Scholar 

  28. Lioznov D, Nikolaenko S. HIV-related stigma among intravenous drug users in St. Petersburg, Russia. 6th IAS Conference on HIV Pathogenesis and Treatment. Rome, 18 July 2011. [abstract CDC429].

  29. Sharma A, Lioznov D, DeHovitz JA. Russian federation. In: Celentano D, Beyrer C, editors. Public health aspects of HIV/AIDS in low and middle income countries: epidemiology, prevention and care. New York: Springer; 2008.

    Google Scholar 

  30. Pisareva A, ROO Community of PLWHIV, UNFPA Russia Country Office, Yuri Levada Analytical Center. Research report people living with HIV stigma index. 2010. http://www.stigmaindex.org/364/analysis/rights-for-plhiv-in-short-supply-in-russia.html. Accessed 3 Sept 2012.

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Acknowledgments

This research was funded by Fulbright-Hays Doctoral Dissertation Research Abroad Award, a Travel Award from The Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, a Royster’s Society of Fellows Doctoral Dissertation Completion Fellowship at the University of North Carolina at Chapel Hill, and a Postdoctoral Training Grant at Yale University’s Center for Interdisciplinary Research on AIDS (T32MH020031) from the National Institute of Mental Health. The content of the manuscript is solely the responsibility of the authors and does not necessarily represent the views of the funding agencies.

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Correspondence to Elizabeth J. King.

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King, E.J., Maman, S., Bowling, J.M. et al. The Influence of Stigma and Discrimination on Female Sex Workers’ Access to HIV Services in St. Petersburg, Russia. AIDS Behav 17, 2597–2603 (2013). https://doi.org/10.1007/s10461-013-0447-7

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