"Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.

<h4>Background</h4>Previous studies have established that sex workers experience discrimination and stigma within healthcare settings, limiting their access and receipt of culturally safe care. These barriers impact sex workers' ability and desire to routinely engage with the health...

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Autores principales:	Randi Beth Singer, Amy K Johnson, Natasha Crooks, Douglas Bruce, Linda Wesp, Alexa Karczmar, Lucy Mkandawire-Valhmu, Susan Sherman
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5cf049fc2e2d4d5fb8439a7b94d5e005
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spelling	oai:doaj.org-article:5cf049fc2e2d4d5fb8439a7b94d5e0052021-12-02T20:09:52Z"Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.1932-620310.1371/journal.pone.0253749https://doaj.org/article/5cf049fc2e2d4d5fb8439a7b94d5e0052021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253749https://doaj.org/toc/1932-6203<h4>Background</h4>Previous studies have established that sex workers experience discrimination and stigma within healthcare settings, limiting their access and receipt of culturally safe care. These barriers impact sex workers' ability and desire to routinely engage with the healthcare system. Community empowerment interventions that are culturally safe offer an effective strategy to improve access to services and health outcomes for sex workers.<h4>Objectives</h4>This project was designed to inform the development of community empowerment interventions for sex workers by understanding their self-management, health promotion, and harm reduction needs.<h4>Methods</h4>In-depth interviews (N = 21) were conducted with sex workers in Chicago. Transcripts of individual interviews were analyzed in Dedoose using rapid content analysis.<h4>Results</h4>Participants had a mean age of 32.7 years; 45% identified as White, 20% as Black, 15% as Latinx, and 20% as multiple races; 80% identified as Queer. A total of 52% of participants identified as cisgender women, 33% as transgender or gender fluid, 10% as cisgender men, and 5% declined to answer. Themes of self-management practices, stigmatizing and culturally unsafe experiences with healthcare providers, and the prohibitive cost of healthcare emerged as consistent barriers to routinely accessing healthcare. Despite identifying patient-centered care as a desired healthcare model, many participants did not report receiving care that was respectful or culturally responsive. Themes also included developing strategies to identify sex worker-safe care providers, creating false self-narratives and health histories in order to safely access care, and creating self-care routines that serve as alternatives to primary care.<h4>Conclusion</h4>Our findings demonstrate how patient-centered care for sex-workers in Chicago might include holistic wellness exercises, accessible pay scales for services, and destigmatizing healthcare praxis. Focus on culturally safe healthcare provision presents needs beyond individualized, or even community-level, interventions. Ongoing provider training and inbuilt, systemic responsivity to patient needs and contexts is crucial to patient-centered care.Randi Beth SingerAmy K JohnsonNatasha CrooksDouglas BruceLinda WespAlexa KarczmarLucy Mkandawire-ValhmuSusan ShermanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253749 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Randi Beth Singer Amy K Johnson Natasha Crooks Douglas Bruce Linda Wesp Alexa Karczmar Lucy Mkandawire-Valhmu Susan Sherman "Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.
description	<h4>Background</h4>Previous studies have established that sex workers experience discrimination and stigma within healthcare settings, limiting their access and receipt of culturally safe care. These barriers impact sex workers' ability and desire to routinely engage with the healthcare system. Community empowerment interventions that are culturally safe offer an effective strategy to improve access to services and health outcomes for sex workers.<h4>Objectives</h4>This project was designed to inform the development of community empowerment interventions for sex workers by understanding their self-management, health promotion, and harm reduction needs.<h4>Methods</h4>In-depth interviews (N = 21) were conducted with sex workers in Chicago. Transcripts of individual interviews were analyzed in Dedoose using rapid content analysis.<h4>Results</h4>Participants had a mean age of 32.7 years; 45% identified as White, 20% as Black, 15% as Latinx, and 20% as multiple races; 80% identified as Queer. A total of 52% of participants identified as cisgender women, 33% as transgender or gender fluid, 10% as cisgender men, and 5% declined to answer. Themes of self-management practices, stigmatizing and culturally unsafe experiences with healthcare providers, and the prohibitive cost of healthcare emerged as consistent barriers to routinely accessing healthcare. Despite identifying patient-centered care as a desired healthcare model, many participants did not report receiving care that was respectful or culturally responsive. Themes also included developing strategies to identify sex worker-safe care providers, creating false self-narratives and health histories in order to safely access care, and creating self-care routines that serve as alternatives to primary care.<h4>Conclusion</h4>Our findings demonstrate how patient-centered care for sex-workers in Chicago might include holistic wellness exercises, accessible pay scales for services, and destigmatizing healthcare praxis. Focus on culturally safe healthcare provision presents needs beyond individualized, or even community-level, interventions. Ongoing provider training and inbuilt, systemic responsivity to patient needs and contexts is crucial to patient-centered care.
format	article
author	Randi Beth Singer Amy K Johnson Natasha Crooks Douglas Bruce Linda Wesp Alexa Karczmar Lucy Mkandawire-Valhmu Susan Sherman
author_facet	Randi Beth Singer Amy K Johnson Natasha Crooks Douglas Bruce Linda Wesp Alexa Karczmar Lucy Mkandawire-Valhmu Susan Sherman
author_sort	Randi Beth Singer
title	"Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.
title_short	"Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.
title_full	"Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.
title_fullStr	"Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.
title_full_unstemmed	"Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.
title_sort	"feeling safe, feeling seen, feeling free": combating stigma and creating culturally safe care for sex workers in chicago.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/5cf049fc2e2d4d5fb8439a7b94d5e005
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"Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.

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