Connaissances, attitudes et pratiques vis-à-vis du VIH et des IST parmi les travailleuses du sexe en Guyane et à Oiapoque, Brésil

Abstract : The HIV epidemic in French Guiana is often described as generalized. However, some vulnerable groups appear particularly affected. Among these groups, female sex workers hold a special place because of the frequency of transactional relationships in the region. These sexual‐economic exchanges go beyond the borders since many customers from French Guiana solicit female sex workers in Oiapoque, the Brazilian border town. Despite the potential importance of sex work in the HIV epidemic, there is scarce data on the subject in the area.The main objective of this study was to address this knowledge gap and to describe the knowledge, attitudes and practices among female sex workers in French Guiana and Oiapoque in order to optimize and subsequently evaluate prevention.The results of the survey conducted in French Guiana and Oiapoque in 2010 and 2011 highlighted a number of events promoting the spread of the epidemic among female sex workers, but also promoting the spread of the epidemic in the general population. Thus, condom use was not always adequate. Although it was consistent with the customers, it was much less with intimate partners, in a common multiple sexual partnerships context. The HIV screening rate was particularly low in Oiapoque as well. Beyond the individual aspect, the structural framework clearly impacted the vulnerability of female sex workers. Thus, the non‐availability of treatment in Oiapoque, the precariousness in which people live and the legislative framework of the two countries are major barriers to female sex workers’ support.Different levels of understanding are necessary to disentangle the complexity of behaviors facing the risk of transmission of HIV among female sex workers. Prevention must be considered at each level, not only at the individual level, to be effective. Furthermore, prevention must be considered more generally to provide an efficient response to the HIV epidemic by combining behavioral, biomedical and structural prevention elements.
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Marie-Claire Parriault. Connaissances, attitudes et pratiques vis-à-vis du VIH et des IST parmi les travailleuses du sexe en Guyane et à Oiapoque, Brésil. Médecine humaine et pathologie. Université de Guyane, 2015. Français. ⟨NNT : 2015YANE0006⟩. ⟨tel-02303080⟩

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