Determinants of Access to Treatment Services for Anal Genital Warts Among Sex Workers Attending Kitengela Sub County Hospital, Kajiado County

Abstract

Background: Human papillomavirus (HPV) infection is transmitted through skin-to- skin contact, with genital and anal sex being the most common transmission routes. Anal-genital warts (AGWs) are benign proliferative skin lesions in the anogenital area caused by low risk HPV strains. Sex workers constitute an epidemiologically important group for HPV infection as they may acquire this infection and transmit it to other sexual partners. An understanding of the determinants of access to treatment services for AGWs is critical for improving care to this vulnerable population. Objective: To establish the determinants of access to treatment services for anal- genital warts among sex workers attending Kitengela Sub County Hospital in Kajiado County. Methods: This was a descriptive cross sectional study conducted among 60 adult sex workers attending the Reproductive Health Unit of Kitengela Sub County Hospital who were selected using census method. An interviewer-administered questionnaire that contained questions based on the study objectives served as the study tool. The study tool was pre-tested at Ngong Sub County Hospital using 10% of the study sample size. The study data was analyzed through descriptive statistics using the Statistical Package for Social Sciences (SPSS, version 25) and presented in percentages and frequencies. Associations between the study variables were evaluated using the Chi-square test at 95% confidence interval. Results are shown in tables, graphs and charts. Informed consent, confidentiality of information obtained, anonymity in reporting study findings, voluntary participation, right of withdrawal and appropriate approvals constituted the study’s ethical principles. Results: All (100%) of the respondents acknowledged as having been diagnosed with anal-genital warts at one point or another. However, only few (12.2%) of the respondents utilized treatment services for anal-genital warts from public health care facilities. Fear of discrimination (83.7%, p = .000), fear of stigma (93.9%, p = .003), fear of social isolation (77.6%, p = .006), low sexual health literacy (79.6%, p = .003) and lack of social support (85.7%, p = .008) were the socio-cultural related factors that led to poor access to treatment services for anal-genital warts among the respondents. Inconvenient clinic schedules (73.5%, p = .001), poor quality of services (100%, p = .000), long waiting times for care (75.5%, p = .010), lack of privacy (91.8%, p = .000) and unawareness about service availability (71.4%, p = .002) were the health system related factors that led to poor access to treatment services for anal- genital warts among the respondents. Conclusion: A wide range of socio-cultural and health system related factors affected access to treatment services for anal-genital warts among sex workers attending Kitengela Sub County Hospital. Recommendations: Efforts are required to improve access to treatment services for anal-genital warts among sex workers attending Kitengela Sub-county Hospital by addressing socio-cultural and systemic challenges that impede their health seeking behaviours.