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Study outlines how to improve healthcare access for sex workers

Many sex workers reported not receiving care that was respectful or culturally responsive. Identified barriers to care included stigmatizing and culturally unsafe experiences with healthcare providers, and the prohibitive cost of healthcare.

Photo by Artem Labunsky from Unsplash.com

Since sex workers continue to face discrimination within healthcare settings, thereby limiting their access to safe care, researchers at the University of Illinois Chicago’s College of Nursing published a study that demonstrated how patient-centered care could be implemented for sex workers.

The paper – “Feeling Safe, Feeling Seen, Feeling Free: Combating stigma and creating culturally safe care for sex workers in Chicago” by Randi Beth Singer, Amy K. Johnson, Natasha Crooks, Douglas Bruce, Linda Wesp, Alexa Karczmar, Lucy Mkandawire-Valhmu, and Susan Sherman – was published in PLOS ONE.

After conducting and then analyzing in-depth interviews with sex workers in Chicago in the US, the study found that many of the sex worker participants reported not receiving care that was respectful or culturally responsive. Identified barriers to care included stigmatizing and culturally unsafe experiences with healthcare providers, and the prohibitive cost of healthcare.

To deal with issues related to accessing healthcare services, the participants reported developing strategies to identify sex worker-safe care providers, creating false self-narratives and health histories in order to safely access care, and creating self-care routines (including yoga and meditation) as alternatives to primary care.

To ensure that healthcare services are inclusive of all those needing them – including sex workers – the researchers stress the need to develop “a culturally safe healthcare”. For instance, acknowledging that patients are experts in themselves, “providers must follow the lead of the patient rather than asking invasive, ignorantly curious, or unnecessary questions.”

Also, there is a need for “ongoing provider training, and inbuilt, systemic responsivity to patient needs and contexts… to patient-centered care.”

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