P3.411 Factors Affecting Utilisation of STI/HIV Clinics Among Sex Workers in Benin,
Bibliographic record
Abstract
Background In Benin, HIV/STI clinical and prevention services (based on community mobilisation activities) for female sex worker (FSWs) were extended throughout the country. However, the attendance of clinical services remains very low. Most of the FSW-dedicated clinics are not functional. Objective This study explores factors related to low functionality and sub-optimal attendance of clinical services by FSWs. Methods Individual interviews and/or focus groups were conducted with 35 FSWs, 50 health care providers, 70 stakeholders from NGOs and 18 departmental heads of the National AIDS Program in 9 of the 12 regions of the country. Interview guides were developed using a conceptual framework describing actors, implications and issues of implementation activities. Direct observations in the field and analysis of activity reports were also conducted. Data from various sources were triangulated and validated with stakeholders. Results Several factors have undermined regular STI services utilisation by FSW, encompassing: (i) incomplete and insufficient package of services, with lack of integration of programme components, irregular and insufficient supervision, recurrent shortages of STI drugs and supplies; (ii) limited involvement of FSWs in the programme design, implementation and service organisation; (iii) police repression resulting in dispersion of FSWs, lack of empowerment activities (structural factors); (iv) fear of stigma, little motivation of some health provider to respond to FSWs needs; (v) dysfunctional referral between community level work and STI clinics. In addition poor planning that does not take into account local needs (size, diversification of sex work typologies) also contributes to the non-functionality of the FSW-dedicated clinical services. Conclusion The results of this study suggest that innovative service delivery models that maximise the synergy between community level work, and uptake of health services need to be designed, implemented and evaluated. Clinical and community level work should also be complemented by appropriate structural interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".