The influence of stigma and discrimination on female sex workers' access to HIV services in St. Petersburg, Russia

AIDS Behav. 2013 Oct;17(8):2597-603. doi: 10.1007/s10461-013-0447-7.


Stigma associated with HIV and risk behaviors is known to be a barrier to health care access for many populations. Less is known about female sex workers (FSW) in Russia, a population that is especially vulnerable to HIV-infection, and yet hard-to-reach for service providers. We administered a questionnaire to 139 FSW to better understand how stigma and discrimination influence HIV service utilization. Logistic regression analysis indicated that HIV-related stigma is negatively associated with uptake of HIV testing, while sex work-related stigma is positively associated with HIV testing. HIV-positive FSW are more likely than HIV-negative FSW to experience discrimination in health care settings. While decreasing societal stigma should be a long-term goal, programs that foster inclusion of marginalized populations in Russian health care settings are urgently needed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • HIV Seropositivity / complications
  • HIV Seropositivity / epidemiology
  • HIV Seropositivity / psychology*
  • Health Services Accessibility* / statistics & numerical data
  • Health Services Needs and Demand
  • Health Status Disparities
  • Humans
  • Prejudice*
  • Risk-Taking
  • Russia / epidemiology
  • Sex Work / psychology*
  • Sex Work / statistics & numerical data
  • Sex Workers / psychology*
  • Sex Workers / statistics & numerical data
  • Sexual Behavior / psychology*
  • Sexual Behavior / statistics & numerical data
  • Social Perception
  • Social Stigma*
  • Surveys and Questionnaires