{"title":"2019冠状病毒病大流行期间，尼日利亚感染艾滋病毒的妇女和女孩难以获得艾滋病毒以及性健康和生殖健康服务的相关因素。","authors":"Morenike Oluwatoyin Folayan, Olujide Arije, Amaka Enemo, Aaron Sunday, Amira Muhammad, Hasiya Yunusa Nyako, Rilwan Mohammed Abdullah, Henry Okiwu, Veronica Akwenabuaye Undelikwo, Pamela Adaobi Ogbozor, Oluwaranmilowo Amusan, Oluwatoyin Adedoyin Alaba, Erik Lamontagne","doi":"10.2989/16085906.2022.2104169","DOIUrl":null,"url":null,"abstract":"<p><p><i>Aim</i>: To determine the proportion of women and girls living with HIV (WGLHIV) who had poor access to HIV, tuberculosis and sexual and reproductive health (SRH) services in Nigeria during the COVID-19 pandemic and associated factors.<i>Methods:</i> This was a cross-sectional study that recruited WGLHIV with six categories of vulnerability (sex work, transactional sex, injecting or using illegal drugs, people on the move, transgender women and people with a disability) through an online survey conducted in ten Nigerian states between june and October 2021. The associations between the limited access to HIV, tuberculosis and SRH services due to COVID-19, the categories of vulnerability and the financial and non-financial barriers to these services were determined using multivariable logistics regression analysis.<i>Results:</i> Over 6 in 10, almost 2 in 10, and almost 4 in 10 WGLHIV had limited access to HIV, tuberculosis and SRH services respectively during the COVID-19 pandemic. Transgender women had 3.59 (95% CI 2.19-5.91) higher odds, women who engaged in sex work had 4.51 (95% CI 2.28-8.42) higher odds, and women who inject or use illegal drugs had 2.39 (95% CI 1.47-32.90) higher odds of facing limited access to sexual and reproductive health services when it was needed. In addition, the direct consequences of the COVID-19 crisis, such as the closure of HIV services and SRH service points, exacerbated pre-existing barriers significantly. Having no money, having to pay additional unofficial fees and the lack of security on the road to the health facility were the barriers with the greatest impact on access to health services.<i>Conclusions:</i> The COVID-19 pandemic had a negative impact on the access of WGLHIV to essential health services. This impact was disproportionately higher for marginalised groups. WGLHIV need non-discriminatory and affordable access to essential health services during the pandemic.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"5","resultStr":"{\"title\":\"Factors associated with poor access to HIV and sexual and reproductive health services in Nigeria for women and girls living with HIV during the COVID-19 pandemic.\",\"authors\":\"Morenike Oluwatoyin Folayan, Olujide Arije, Amaka Enemo, Aaron Sunday, Amira Muhammad, Hasiya Yunusa Nyako, Rilwan Mohammed Abdullah, Henry Okiwu, Veronica Akwenabuaye Undelikwo, Pamela Adaobi Ogbozor, Oluwaranmilowo Amusan, Oluwatoyin Adedoyin Alaba, Erik Lamontagne\",\"doi\":\"10.2989/16085906.2022.2104169\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><i>Aim</i>: To determine the proportion of women and girls living with HIV (WGLHIV) who had poor access to HIV, tuberculosis and sexual and reproductive health (SRH) services in Nigeria during the COVID-19 pandemic and associated factors.<i>Methods:</i> This was a cross-sectional study that recruited WGLHIV with six categories of vulnerability (sex work, transactional sex, injecting or using illegal drugs, people on the move, transgender women and people with a disability) through an online survey conducted in ten Nigerian states between june and October 2021. The associations between the limited access to HIV, tuberculosis and SRH services due to COVID-19, the categories of vulnerability and the financial and non-financial barriers to these services were determined using multivariable logistics regression analysis.<i>Results:</i> Over 6 in 10, almost 2 in 10, and almost 4 in 10 WGLHIV had limited access to HIV, tuberculosis and SRH services respectively during the COVID-19 pandemic. Transgender women had 3.59 (95% CI 2.19-5.91) higher odds, women who engaged in sex work had 4.51 (95% CI 2.28-8.42) higher odds, and women who inject or use illegal drugs had 2.39 (95% CI 1.47-32.90) higher odds of facing limited access to sexual and reproductive health services when it was needed. In addition, the direct consequences of the COVID-19 crisis, such as the closure of HIV services and SRH service points, exacerbated pre-existing barriers significantly. Having no money, having to pay additional unofficial fees and the lack of security on the road to the health facility were the barriers with the greatest impact on access to health services.<i>Conclusions:</i> The COVID-19 pandemic had a negative impact on the access of WGLHIV to essential health services. This impact was disproportionately higher for marginalised groups. WGLHIV need non-discriminatory and affordable access to essential health services during the pandemic.</p>\",\"PeriodicalId\":50833,\"journal\":{\"name\":\"Ajar-African Journal of Aids Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2022-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ajar-African Journal of Aids Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2989/16085906.2022.2104169\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ajar-African Journal of Aids Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2989/16085906.2022.2104169","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 5
摘要
目的:确定在2019冠状病毒病大流行期间，尼日利亚感染艾滋病毒(WGLHIV)的妇女和女孩难以获得艾滋病毒、结核病和性健康和生殖健康(SRH)服务的比例及其相关因素。方法:这是一项横断面研究，通过2021年6月至10月在尼日利亚10个州进行的在线调查，招募了六类易损性人群(性工作、性交易、注射或使用非法药物、流动人群、跨性别女性和残疾人)。利用多变量logistic回归分析确定了COVID-19导致的艾滋病毒、结核病和性健康和生殖健康服务的有限获取、脆弱性类别以及这些服务的财务和非金融障碍之间的关联。结果:在COVID-19大流行期间，超过6 / 10、近2 / 10和近4 / 10的WGLHIV获得艾滋病毒、结核病和性健康生殖健康服务的机会分别有限。变性妇女的几率高出3.59 (95% CI 2.19-5.91)，从事性工作的妇女的几率高出4.51 (95% CI 2.28-8.42)，注射或使用非法药物的妇女在需要时获得性和生殖健康服务的机会有限的几率高出2.39 (95% CI 1.47-32.90)。此外，COVID-19危机的直接后果，如关闭艾滋病毒服务和性健康和生殖健康服务点，大大加剧了原有的障碍。没有钱、必须支付额外的非官方费用以及前往保健设施的道路缺乏安全是对获得保健服务影响最大的障碍。结论:COVID-19大流行对WGLHIV获得基本卫生服务产生了负面影响。这种影响对边缘群体的影响更大。全球艾滋病毒感染者需要在大流行期间获得不歧视和负担得起的基本保健服务。
Factors associated with poor access to HIV and sexual and reproductive health services in Nigeria for women and girls living with HIV during the COVID-19 pandemic.
Aim: To determine the proportion of women and girls living with HIV (WGLHIV) who had poor access to HIV, tuberculosis and sexual and reproductive health (SRH) services in Nigeria during the COVID-19 pandemic and associated factors.Methods: This was a cross-sectional study that recruited WGLHIV with six categories of vulnerability (sex work, transactional sex, injecting or using illegal drugs, people on the move, transgender women and people with a disability) through an online survey conducted in ten Nigerian states between june and October 2021. The associations between the limited access to HIV, tuberculosis and SRH services due to COVID-19, the categories of vulnerability and the financial and non-financial barriers to these services were determined using multivariable logistics regression analysis.Results: Over 6 in 10, almost 2 in 10, and almost 4 in 10 WGLHIV had limited access to HIV, tuberculosis and SRH services respectively during the COVID-19 pandemic. Transgender women had 3.59 (95% CI 2.19-5.91) higher odds, women who engaged in sex work had 4.51 (95% CI 2.28-8.42) higher odds, and women who inject or use illegal drugs had 2.39 (95% CI 1.47-32.90) higher odds of facing limited access to sexual and reproductive health services when it was needed. In addition, the direct consequences of the COVID-19 crisis, such as the closure of HIV services and SRH service points, exacerbated pre-existing barriers significantly. Having no money, having to pay additional unofficial fees and the lack of security on the road to the health facility were the barriers with the greatest impact on access to health services.Conclusions: The COVID-19 pandemic had a negative impact on the access of WGLHIV to essential health services. This impact was disproportionately higher for marginalised groups. WGLHIV need non-discriminatory and affordable access to essential health services during the pandemic.
期刊介绍：
African Journal of AIDS Research (AJAR) is a peer-reviewed research journal publishing papers that make an original contribution to the understanding of social dimensions of HIV/AIDS in African contexts. AJAR includes articles from, amongst others, the disciplines of sociology, demography, epidemiology, social geography, economics, psychology, anthropology, philosophy, health communication, media, cultural studies, public health, education, nursing science and social work. Papers relating to impact, care, prevention and social planning, as well as articles covering social theory and the history and politics of HIV/AIDS, will be considered for publication.
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