Facilitators and Barriers to Health Seeking Behavior Among Sex Workers and Drug Addicts in Lusaka District, Zambia
Tinkler Saul Simbeye*, Nneoma Natalie Wosu, Charity M. Chimwala-Selico, Lee A. Selico II, Mumba Mwanza, Lloyd K Zhuwau, Lexinah Chileshe, Mwangala Goma and Remmy Mulenga
ABSTRACT
Introduction: The behavior of seeking health services among sex workers and drug addicts is a complex concept shaped by diverse factors on a global scale. They also confront heightened levels of stigma, discrimination, social exclusion, violence, human rights abuses, and legal prosecution. This study aimed to assess the facilitators and barriers to health-seeking behavior among sex workers and drug addicts in Lusaka district of Zambia.
Methods: Ethical approval for this study was obtained from the Lusaka Apex Medical University Biomedical Research Ethics Committee (LAMUBREC), IRB number 00001131, as well as from participating brothels, nightclubs, and bars. A cross-sectional study design was utilized in this study to assess the facilitators and barriers to health seeking behavior among sex workers and drug addicts in Lusaka district of Zambia. Also100 study participants aged 18–45 years were selected through simple random sampling to take part in the study. The total sample size for this study was 100 respondents. The study participants were also informed that participation in the study was completely voluntary and that they were free to opt out of the study at any point without any coercion or consequence. Other than that, a written informed consent was also obtained from the respondents before the researchers proceeded with data collection exercise. Primary data was collected from respondents using structured questionnaire with closed ended questions and was analyzed using SPSS version 28 and MS Excel. Multivariate logistic regression analysis examined associations between socio-demographic factors and health-seeking behaviors parameters, with significance set at p<0.05.
Results: The study found that, most of the respondents (81%) had high awareness of available health services, and 92% knew services’ locations. Perceptions of healthcare quality and accessibility were favorable in that; a significant majority of study participants (75%) expressed their belief in the good quality of healthcare services within the district. The study also uncovered that an overwhelming majority of participants (75%) concurred that healthcare services were adequately tailored to meet the specific needs of key populations. Nevertheless, a substantial proportion of respondents (78%) acknowledged encountering financial barriers to accessing healthcare services within the district. The study also revealed that a significant majority of key populations (68%) agreed that healthcare services are readily available in health care facilities when needed. The study further revealed that, cultural and social factors, stigma, and discrimination significantly influenced health-seeking behaviors (80.8%) among sex workers and drug addicts. Also 75% of respondents agreed that existing programs effectively promoted positive health-seeking behaviours among this population. Age and education were significantly associated with cultural and societal factors towards health-seeking behaviours among sex workers and drug addicts (p<0.05). These associations imply that interventions should be tailored according to demographic characteristics, with more focused strategies for younger and less-educated individuals who may be more vulnerable to negative influences.
Conclusion: Community engagement and sensitization, strengthened social mobilization, supportive public health policy reforms, and ongoing health education for healthcare providers are essential for building trust, promoting dignity, reducing stigma and discrimination, fostering inclusive and nonjudgmental healthcare environments, and ensuring equitable access to healthcare services for sex workers and drug users in Lusaka District, Zambia.
