Sexual Reproductive Health & Rights

Chapter 14: Ensuring Sex Workers Access Healthcare When They Need It

Posted On
Tuesday, September 10, 2019

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#15yearsofimpact

Many health interventions use a peer educator model, but is it really effective? A study shows that peers can indeed positively influence decisions to seek healthcare.

Peer-led outreach is a critical element of HIV and Sexually Transmitted Infection (STI) reduction interventions aimed at sex workers. Swasti studied the association between peer-led outreach to sex workers and the time to utilise health facilities for timely STI syndromic detection and treatment.

A study led by the University of Houston and co- authored by Swasti, used data from 2,705 women sex workers registered under Pragati, a women-in- sex-work outreach programme, from 2008 through 2012. The study used data on the timing of peer- outreach interventions and clinic visits, among sex workers. The team used an Extended Cox model, with the density of peer educator visits in a 30-day rolling window as the the key predictor, while controlling for the sex workers’ age, client volume, location of sex work and education level.

The principal outcome of interest is the timing of the first voluntary clinic utilisation. Researchers wanted to see how soon after meeting the peer did the woman sex worker voluntarily go to a clinic for a check-up or treatment.

Researchers found that the more the peer visits, the earlier the women visited clinics for the first time. (HR: 1.83, 95% CI, 1.75–1.91, p < .001). 18 per-cent of all syndrome-based STIs detected come from clinic visits in which the sex worker reports no symptoms, underscoring the importance of inducing clinic visits in the detection of STI.

The researchers found that clinic utilisation results in the detection of STI syndromes that the sex worker would have otherwise missed. This under scores both the importance of peer-led outreach and the role of clinic visits. By encouraging sex workers to come to the clinic, the outreach workers are helping detect STI that would have otherwise gone unnoticed. 

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Chapter 14: Ensuring Sex Workers Access Healthcare When They Need It

Many health interventions use a peer educator model, but is it really effective? A study shows that peers can indeed positively influence decisions to seek healthcare.