Submission ID 118555
| Issue/Objective | Female sex workers (FSWs) face discrimination and barriers to accessing sexual and reproductive health (SRH) care. The COVID-19 pandemic has deepened these inequities. To prepare for future emergencies, it is important to identify novel healthcare models for vulnerable populations. "MAS por nosotras" project aimed to identify gaps, generate evidence, and combine expertise to design a SRH care and prevention package for FSWs. |
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| Methodology/Approach | Initiated in December 2022, this study brought together a Canadian research team, an Argentinean NGO and research center, the Ministry of Health of Buenos Aires (MoH), and two community-based organizations of cisgender and transgender FSWs. The first phase involved participatory qualitative research, including stakeholder mapping, key informant interviews with healthcare workers and policy makers, and two FSWs´ focus groups. In the second phase, we recruited a prospective cohort of 200 FSWs (101 cisgender, 99 transgender women) (June 2023-March 2024) through peer navigators´ support and facilitated referrals, with 133 participants completing the 6-month follow-up. Medical and psychosocial assessments were conducted, including HIV/ STI testing, cancer screening and contraception counseling. Finally, a policy brief was developed to inform deliberative dialogues with policy-makers. |
| Results | The MAS por Nosotras model promotes recruitment and retention of users through collaboration with community-based organizations, peer navigators in services, personalized care, and economic and educational incentives. The cohort showed high prevalence of STIs (including HIV) and undiagnosed or poorly managed physical and mental health conditions. Key barriers included inadequate referral pathways, stigma, and lack of culturally competent care. We propose intersectional care, redesigning existing referrals between primary healthcare centers and hospitals, assuring person-centered care. The model includes strengthening care through training, task delegation, ensuring communication between different levels of care, and focusing simultaneously on users and healthcare services. |
| Discussion/Conclusion | This project created a unique opportunity to work with FSWs, a vulnerable and understudied population addressing knowledge-to-action gaps to inform public policies. Key accomplishments include the co-development of a care model through partnerships between community, a research center, and government to ensure equity that can be adapted to other vulnerable women. This project was funded under the Women RISE initiative supported by IDRC, CIHR and SSHRC. |
| Presenters and affiliations | Valeria Fink Fundación Huésped Macarena Sandoval Fundación Huésped Silvina Vulcano Coordination of Sexual Health, HIV and Sexually Transmitted Infections of the Ministry of Health of Buenos Aires Camila Serrao Fundación Huésped Rodrigo Acuña Fundación Huésped Maria Celia Trejo Fundación Huésped Emilia Frontini Fundación Huésped Ana Zeltman Fundación Huésped Agustina Argüello Fundación Huésped Nadir Cardozo Fundación Huésped Mariana Duarte Fundación Huésped Solange Fabian Fundación Huésped Marcela Romero Asociación de Travestis, Transexuales y Transgénero de Argentina Georgina Orellano Sindicato de Trabajadorxs Sexuales de Argentina Eugenia Esandi Fundación Huésped Zulma Ortiz Fundación Huésped María Inés Figueroa Fundación Huésped Pedro Cahn Fundación Huésped Mona Loufty Women's College Hospital, University of Toronto Adriana Durán Coordination of Sexual Health, HIV and Sexually Transmitted Infections of the Ministry of Health of Buenos Aires Inés Arístegui Fundación Huésped Sharon Walmsley University Health Network, University of Toronto |
