Female sex workers'experiences of the sexual reproductive health(SRH)services on the emerging voices project in Chipata district in Zambia

Abstract

The number of people living with HIV and AIDS has continued to rise globally despite the significant effort and resources invested in prevention programmes worldwide. Epidemiologically, majority of new HIV infections in Asia occur in individuals who are at high risk. This is so in many other parts of the world including Zambia. Although Female Sex Workers (FSW’s) are among the most at risk, they are often deterred from seeking health services because of stigma associated with their work. The hostile legal environment concerning sex work in Zambia and the unfriendly and discriminatory health services provided discourage them from accessing Sexual Reproductive Health (SRH) services thereby increasing the risk of infections and re-infections of HIV/AIDS and Sexually Transmitted Infections(STI’s) among them and their partners who may be the general population. The Southern African AIDS Trust (SAT Zambia) identified this gap in the fight against HIV/AIDS following a base line survey in 2013 which resulted in – The Emerging Voices Project in Chipata District. This study aimed at exploring the Female Sex Workers’ lived experiences of the SRH services on the Emerging Voices Project in Chipata District – Zambia. Using a Phenomenological study design, this study aimed to explore the Female Sex Workers’ lived experiences and acceptability of the Sexual Reproductive Health (SRH) services on the project. The study findings revealed that the FSWs had challenges accessing SRH services before the Emerging Voices Project. From their perspective, they shunned health facilities because of the experience of discriminatory and unfriendly health services. The barriers to their utilization of the SRH services included the cost of SRH services, a poor referral system, fear to test positive and lack of knowledge of SRH services. However, the Projects’ creation of the Taskforce and Hubs, introduction of Peer Educators, facilitated the FSWs rights to health in the community and amongst the Health workers and improved the acceptability, adoption and utilization of SRH services in among the FSWs. The lived experiences of the FSW’s SRH needs highlighted in this study challenge the unfriendly and discriminatory health services in Chipata District prior to the Emerging Voices Project. The adoption and utilization of the SRH services now by FSW’s inform policy on the importance of decriminalization of sex work in Zambia to ultimately promote good health seeking behaviors and reduce the HIV prevalence among the FSW and the general population. These study findings are of particular importance to refocusing of HIV/AIDS prevention and treatment initiatives on targeted groups. It generates evidence for expansion and replication of similar impactful interventions in the HIV/AIDS fight.