Enhancing Access to Sexual Health Services for Female Sex Workers in Arak: Insights from a Qualitative Study

This study looked into the sexual health needs of female sex workers and the challenges they face in getting health services. Many of these challenges come from feelings of shame, embarrassment, and fear of being identified. These feelings often stem from cultural traditions. The women also struggled with a lack of information about sexual health, leading to fears about diseases and discouraging them from seeking help. A recent review highlighted similar issues faced by men who have sex with men, showing that fear and stigma are big barriers in accessing sexual health services.

Environmental factors also played a role. Many sex workers found health services and STI medications too expensive, and a lack of financial resources made access even harder. Unfortunately, mistreatment by healthcare providers and their judgmental attitudes created further obstacles. A study in Uganda revealed that discrimination and breaches of confidentiality were major concerns for sex workers when trying to get STI care.

On the positive side, some factors helped these women seek health services. When clients felt respected and supported without judgment, they were more willing to visit health centers. Access to free condoms and HIV testing also encouraged women to utilize these services. Research shows a range of barriers and helpers affect sex workers’ use of healthcare, including awareness, stigma, social support, and the quality of services.

The participants also expressed a need to establish boundaries in sexual relationships, like insisting on condom use and asking partners to get tested. However, they often struggled to set these boundaries. To help, training in negotiation and communication skills is crucial. In Malaysia, research showed that many women find it hard to negotiate for safe sex, even if they are informed about health issues. This highlights the need for policies promoting condom use in places where sex work occurs. Studies in Africa reflected similar challenges, showing that women’s socio-economic status and their ability to negotiate significantly impact their risk for STIs.

Body image was another important issue. Many women felt that looking good was key to their sexual relationships but often doubted their attractiveness. Building self-esteem and helping them accept their bodies could lead to healthier relationships. A past study pointed out that respect for body image plays a significant role in how people perceive sexual attractiveness.

To prevent STIs, sex workers tried to use condoms and look for symptoms in their partners. They need proper education about reproductive health and STI prevention. Many hold misconceptions about STIs, believing they are incurable or have extremely painful treatments. Addressing these misconceptions and teaching negotiation skills is essential in promoting safer practices among this at-risk group.

Peer education was seen as both beneficial and challenging. While it creates comfort through shared experiences, there was also concern about trusting the information from peers. Most preferred structured educational sessions where they could share and empathize with each other. Trained peer educators could facilitate these discussions, enhancing understanding and shared learning. Previous studies support the effectiveness of peer education in encouraging behavior change among high-risk groups.

Although the study’s participants were from a specific HIV center, which may not represent all sex workers, their insights are crucial. Many of them showed good awareness of health issues because of their access to services. To better understand the needs of sex workers, future research should include those more engaged in the community and not just those who visit clinics.

Providing home-based sexual health services could help address privacy and accessibility issues. Research indicates this approach is essential and currently lacking in Iran’s healthcare system. By enhancing trust and confidentiality, home-based services could significantly improve health outcomes for female sex workers.

In conclusion, this study sheds light on the barriers and facilitators faced by female sex workers in accessing sexual health services. Addressing these challenges is essential for improving their access and well-being. This involves creating a respectful service environment, offering education, and exploring home-based care options. Additionally, reducing stigma and integrating these insights into public health policies is critical to better support this vulnerable group.