Table 2 Barriers to access and utilisation of HIV/STI prevention services and coping strategies among trans-women sex workers in the greater Kampala metropolitan region, Uganda
Themes | Organising themes | Basic themes |
|---|---|---|
Barriers | Individual level barriers | Internalised stigma |
Low socio-economic status | ||
Community level barriers | Transphobia | |
| Â | Healthcare system barriers | Social exclusion and lack of recognition by other key population groups |
Stigmatisation by some healthcare providers at key population-friendly healthcare facilities | ||
Breach of confidentiality by some healthcare providers | ||
Limited hours of operation of some key population-friendly healthcare facilities | ||
Discrimination by some healthcare providers due to the transgender identity | ||
Discrimination by straight patients because of being a transgender | ||
Stockout of STI drugs, lubricants and other medical supplies | ||
Inadequate availability of well-equipped treatment centres | ||
High cost of drugs | ||
Coping strategies | Coping with inadequate access to lubricants and STI drugs | Use of substitutes such as lotions, avocado, egg white or yoghurt to cope with a lack of lubricants |
Resorting to use of herbs to cope with inadequate access to STI drugs | ||
Coping with stigma and discrimination | Use psychoactive substances to cope with stigma and discrimination | |
Changing the dress code to hide their preferred gender identity |