Commercial sex workers
COMPREHENSIVE HIV/AIDS PROGRAM – TURKANA
Focus Group Discussion Tool 7: Commercial sex workers (women who interact a lot with men)
- Participants should not exceed 12 per FGD
- This tool will be used in all the six partner sites
- This tool can be administered ONCE per site –
- The choice for the sample size should be as representative as possible i.e. area distribution of CSWs.
- The services being assessed are those being provided by the IRC partner at that particular site.
- The facilitator should take time to assess other similar services offered by other agencies in that site/or lack of other players
- Required persons for exercise – Experienced facilitator and two note takers. An observer could also help.
1.1. What is your understanding of HIV and AIDS?
- Ø HIV is a virus
- Ø The mention of the word HIV provokes a feeling of fear to me.
- Ø When I think about HIV, the question about my status come in.
- Ø AIDS is the maturity of HIV
- Ø AIDS is a stage where signs and symptoms appear.
1.2. You as women who interact a lot with men, how has HIV affected you?
- Ø Many People that we know have died and are still dying.
- Ø Health is deterioriating.
- Ø Loss of money treating illnesses related to AIDS.
- Ø Have suicidal thoughts because of fear.
- Ø Psychological stress.
- Ø Always anticipating infection with HIV.
- Ø I am afraid that some of my clients may be infected.
- Ø Our lives is always in temptation and at risk
- Ø Loss of manpower in our workplaces.
B. HIV awareness services
2.1. What HIV awareness services do you as women who interact a lot with men receive from the implementers?
Probe on the IRC supported services on the following:
- Ø Very little awareness services have targeted us.
- Ø We only hear from other people, but no implementer has come out to talk to us particularly in our places of work.
- Treatment of those infected
- Ø ARVs are available at Lodwar District Hospital
- Available and use of male condoms and female condoms
- Ø MOH and Merlin fill the condom dispensers and are available at the bars.
- Ø Only male condoms are available. No female condoms.
- Ø Some of our clients do not prefer using condoms.
- Ø Some clients do not know how to use the condom properly.
- Ø Many people prefer buying branded condoms to using MOH supplied condom, because they look attractive.
2.2. Are the HIV awareness services you receive adequate?
- Ø Awareness services are not adequate to all, we are not well informed about HIV/AIDS.
2.3. What other efforts can be made for you to get better HIV prevention services that serve you well?
- Ø We should be educated and trained on HIV/AIDS
- Ø IRC to organise training for us.
- Ø Empower us to know how to use condoms properly.
- Ø Constant supply of male and female condoms.
2.4. What would be your role as women who interact a lot with men in promoting HIV prevention awareness in this town?
- Ø To advise our male clients to use condom properly always.
- Ø Educate others on how to use condom at our workplaces.
- Ø Always carry condoms for protection.
- Ø Get one sexual partner.
- Ø Reduce the number of sexual partners to reduce the risk.
- Ø I need to talk freely about prevention to my clients.
C. Counselling and testing services
3.1. Where do you receive your C/T services in this town?
- Ø Lodwar District Hospital (Lab and VCT)
- Ø Even pregnant women are tested
- Ø Kanamkemer dispensary.
- Ø Mobile VCT by Merlin
- Ø Napetet dispensary
- Ø Nakwamekwi Dispensary.
- Ø The services are near to us, but depend on individual how wants them.
3.2. When do you – as women who interact a lot with men – seek C/T services?
Why do you seek CT services?
- Ø When I am suspecting that am sick.
- Ø I go after every three months just to be sure of myself.
- Ø To know my status and if am infected to plan for my life.
- Ø I have not visited any VCT in my Life since I was faithful to my husband before we divorced but now I will visit because I meet with many men.
(a) Challenges in accessing services
- Ø Fear of many questions asked in VCT.
- Ø I fear to know that I have HIV.
- Ø Stress associated with AIDS.
- Ø Because I have not used a condom, may be I am infected.
- Ø I do not want anybody to know my status.
- Ø I fear to tell others my status because they will reject me.
- Ø Many people think that HIV for prostitutes only.
(b) How we can improve
- Ø Come and counsel and test us at our places of work.
- Ø Encourage sexual partners to know their status together.
- Ø Mass campaign for counselling and testing services.
3.5. (a) Can you comment on stigma associated to HIV in this town?
- Ø Stigma is still high in Lodwar town.
- Ø People who are positive are isolated and called name like; walking coffins etc.
- Ø Many people fear to test for HIV because they fear others will know.
(b) What can be done to lessen the stigma associated to HIV in this community?
- Ø Create more awareness of HIV.
- Ø Give people information.
- Ø Take testing to the people.
- Ø People to change their attitudes about those infected with HIV.
- Ø PLHWA to be supported.
(c) How do you think you as women who interact a lot with men can contribute towards lessening stigma on HIV in this town?
Do not talk badly about PLWHA
Support colleagues who are infected.
Be well informed about HIV/AIDS.
Tell my colleagues that stigma is bad.
D. Treatment and Support
4.1. What kinds of support services are available in the community for PWHA?
- Ø ARVS
- Ø Nutritional support.
- Ø Counseling
- Ø Spiritual support
- Ø They are allowed to form support groups
4.2. Where do PWHA access ARVs?
- Ø Lodwar District Hospital
- Ø Napetet dispensary
- Ø Nakwamekwi
E. Sexually transmitted diseases
4.1. What is your view on STI among women who interact a lot with men?
- Ø STI are high especially if condoms are not use.
- Ø Some times I fear to disclose that I have STI.
- Ø They are related to HIV because are also sexually transmited
4.2. What is the status of STI treatment in this town?
- Ø STI treatment is readily available in LDH and private clinics.
List in order of preference where women who interact a lot with men prefer to receive STI services.
- Ø We would prefer LDH because there are no charges.
4.2. Assess in your own view the STI services in the IRC supported site.
- Ø STI services are accessible
(b) Quality of services
- Ø Services are of quality
(c) Staff handling
- Ø Good handling but sometimes a lot of delays.
- Ø Is not very much guaranteed, some staff my leak your secrets.
(e) Other treatment alternatives
- Ø Herbal medicines by Kenya Neem Foundation
- Ø Maasai herbs
4.4. What more can be done by:
- the implementers
- Ø Continue to make STI services free and available.
- Ø All staff to maintain confidentiality.
- Yourselves; to improve on the delivery of the services you receive from the implementing partner?
- Ø To go for STI check ups always
- Ø To get early treatment if I have STI.
- Ø Use condom to protect myself from STI
F. Home based care
6.1. Comment on the status of HBC in your community.
- Ø We are not aware of HBC services in this community
There is need of HBC services because many patients are at their home.
6.2. What in your view would be your role in making the HBC services better in this community?
- Ø Inform others that these services are there.
7.1. What role do you think you can play in shaping the condition of HIV/AIDS in this community?
- Ø Educate community about dangers of HIV/AIDS.
- Ø Use condoms to protect my self and others.
- Ø Make condoms available to my clients always.
- Ø Give information to my colleagues and employer.
- Ø Support those infected.
- Ø Seek Counselling and testing.
- Ø Seek treatment if I am infected
7.2. What can us as service providers do to work better with you in this town – for better delivery of services?
- Ø Train us on HIV/AIDS
- Ø Target even our employers
- Ø Constant supply of condoms to us
7.3. What in your view are the major strengths/successes of the HIV/AIDS program in this town?
- Ø Availability of free ARVs.
- Ø Availability of CT services.
7.4. What are the major weaknesses of this program?
- Ø No nutritional support for PLWHA.
- Ø Some medicines are sometimes missing
- Ø We are not directly targeted.
- Ø Few posters and pamphlets available in Bars.
7.5 What can be done in general by the implementers to improve services?
- Ø Improve nutrition component.
- Ø More CT services
- Ø Make medicines available
- Ø Increase posters and pamphlets
- Ø Target all groups in the community
Any other comments they may have.