Utilisation of sexual health services by female sex workers in Nepal
Statistics indicate that more than half of the women with sexually transmitted infections in Nepal sought sexual health services. This study explores female sex workers (FSWs) use of sexual health services in Nepal and the factors associated with their use and non-use of services.
The paper points that FSWs participating in the study were from diverse backgrounds in terms of age, education, marital status, caste, ethnicity and work settings. Findings are as follows:
- 90% FSWs self-reported sickness, and (30.8%) reported symptoms of sexually transmitted infections (STIs).
- a quarter of those reporting STIs had never visited any health facilities.
- FSWs face lack of privacy and confidentiality at government health facilities, which creates distrust and hinders the use of public sexual health services.
- still, higher fees for services at private clinics prevent the use of private sexual health services.
- notably, separated, married and street- based FSWs are more likely to seek health services from the clinics or hospitals.
Conclusions can be viewed like this:
- FSWs have limited access to information and to health services, and operate under personal, structural and socio-cultural constraints.
- social stigma attached with fear of exposure as a sex worker and health worker discrimination and judgmental behaviours appear to be the major barriers to seeking health services.
- as a result, the ‘education’ to change individual behaviour, health worker and community perceptions, as well as the training of the health workers, is necessary.