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P4.73 Attitudes and practices of nurses upon the delivery of health care to commercial sex workers (CSW) in the western province, sri lanka
  1. N Jayasinghe1,
  2. S Tissera2,
  3. N Silva3
  1. 1Deputy Head – Nursing Faculty, International Institute of Health Sciences, Sri Lanka
  2. 23rd year student, Nursing Faculty, International Institute of Health Sciences, Sri Lanka
  3. 3Head of Academic Affairs, International Institute of Health Sciences, Sri Lanka


Introduction The traditional socio-cultural norms of countries like Sri Lanka pose challenges to health care access to those engaged in tabooed and illegal professions like the commercial sex trade. CSWs accessing health services in similar countries have been proven to be of a low socio-economic background. Therefore it is important to prompt a behavioural change by placing strong policies in place to address the psychosocial issues of both the patient and the carer. Certain STI’s like HIV, being immuno-compromising in nature, increase the susceptibility of many other illnesses, to which these CSWs should seek treatment promptly. In order to make policy level decisions to tailor the training of health care workers to improve acceptance of CSWs at their settings, it is first important to assess the current gaps in delivering holistic care to CSWs. The goal was to understand attitudes and perceptions of nurses (in multi-sectors) when attending to sexual and general health needs and delivering holistic health care to CSWs in the Western Province of Sri Lanka.

Methods A qualitative research which consisted of 3 focus group discussions were carried out on a total of 23 nurses from the government and private sectors where each group consisted of 7–8 participants with 2 moderators per group. Scenarios and questions were posed to evaluate the perceptions of nurses towards CSWs when delivering STI related and general health care.

Results Thematic analysis revealed three strong themes. They were, ‘No difference in the level of care delivered’, ‘Social marginalisation based on assumptions’ and ‘Labelling and stereotyping of CSWs’. No difference was made in the level of care provided for CSWs compared to non-CSWs, or for STIs compared to other disease conditions. Though the level of care delivered is the same, the manner in which CSWs are ‘made comfortable’ in terms of ‘holistic care’ within the hospitals seemed less compared to other patients. Labelling and stereotyping were common practices, where the nurses did believe that their attitudes and behaviour could have a negative affect on health promotion and health seeking behaviour.

Conclusion It is better to invest on training nurses so that the CSWs are made to feel more accepted when accessing STI related and general health care needs.

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