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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

From: Barriers to access and utilisation of HIV/STIs prevention and care services among trans-women sex workers in the greater Kampala metropolitan area, Uganda

Themes Organising themes Basic themes
Barriers Individual level barriers Internalised stigma
Low socio-economic status
Community level barriers Transphobia
  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