Barriers to free antiretroviral treatment access for female sex workers in Chennai, India
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This article is important because it highlights the level of stigma experienced by women who are involved in sex work and are HIV-positive, thus experiencing a double stigma. Because of this, the sex workers were said to not practise self-disclosure so as to seek antiretroviral treatment (ART). Precisely the same thing is being observed at the Kenya Voluntary Women Rehabilitation Centre where self-disclosure and antiretroviral (ARV) adherence is quite a struggle due to stigma. This study is about women in the sex trade who are HIV positive and have inhibitions in attending health services and seeking ART. Firstly, they are women who invariably experience a lower status in society and the family; and secondly, the existence of unfriendly health and social systems that do not persuade these women to seek services has added to the level of stigma. Also, being both sex-workers and HIV positive makes these women's situations especially difficult. Fear of disclosure was found in this study, and this too has been experienced by the Centre for HIV Prevention and Research (unpublished data) where female sex workers have reported a triple stigma. Understandably, and as reported by this paper, they lack knowledge due to the fact that they have barriers in seeking HIV/AIDS services. The future research should be directed towards investigating how to integrate HIVI/AIDS care and support for women in the sex industry, and also investigating the best ways to prepare counsellors and other social- and health-care providers better so as to meet the needs of this sub-group of our population. Training of counsellors who deal with female sex workers in government hospitals and nongovernmental organizations in Kenya should be geared towards the teaching of antiretroviral treatment issues and providing better support, especially for those who have HIV/AIDS.