Barriers to cervical screening among sex workers in vancouver

P. Duff, G. Ogilvie, J. Shoveller, O. Amram, J. Chettiar, P. Nguyen, S. Dobrer, J. Montaner and K. Shannon

American Journal of Public Health, 2016, vol. 106, issue 2, 366-373

Abstract: Objectives. We longitudinally examined the social, structural, and geographic correlates of cervical screening among sex workers in Metropolitan Vancouver, British Columbia, to determine the roles that physical and social geography play in routine reproductive health care access. Methods. Analysis drew on (2010-2013) data from an open prospective cohort of sex workers (An Evaluation of Sex Workers' Health Access). We used multivariable logistic regression with generalized estimating equations (GEE) to model correlates of regular cervical screening. Results. At baseline, 236 (38.6%) of 611 sex workers in our sample had received cervical screening, and 63 (10.3%) were HIV-seropositive. In multivariable GEE analysis, HIV-seropositivity (adjusted odds ratio [AOR] = 1.65; 95% confidence interval [CI] = 1.06, 2.58) and accessing outreach services (AOR = 1.35; 95% CI = 1.09, 1.66) were correlated with regular cervical screening. Experiencing barriers to health care access (e.g., poor treatment by health care staff, limited hours of operation, and language barriers) reduced odds of regular Papanicolaou testing (AOR = 0.81; 95% CI = 0.65, 1.00). Conclusions. Sex workers in Metropolitan Vancouver had suboptimal levels of cervical screening. Innovative mobile outreach service delivery models offering cervical screening as one component of sex worker-targeted comprehensive sexual and reproductive health services mayhold promise.

Keywords: adolescent; adult; British Columbia; early cancer diagnosis; female; health care delivery; human; Papanicolaou test; prospective study; psychology; sex worker; spatial analysis; statistical model; Uterine Cervical Diseases; Uterine Cervical Neoplasms; utilization; young adult, Adolescent; Adult; British Columbia; Early Detection of Cancer; Female; Health Services Accessibility; Humans; Logistic Models; Papanicolaou Test; Prospective Studies; Sex Workers; Spatial Analysis; Uterine Cervical Diseases; Uterine Cervical Neoplasms; Young Adult (search for similar items in EconPapers)
Date: 2016
References: Add references at CitEc
Citations:

Downloads: (external link)
http://hdl.handle.net/10.2105/AJPH.2015.302863

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2015.302863_7

DOI: 10.2105/AJPH.2015.302863

Access Statistics for this article

American Journal of Public Health is currently edited by Alfredo Morabia

More articles in American Journal of Public Health from American Public Health Association
Bibliographic data for series maintained by Christopher F Baum ().