Uptake of Hepatitis B services and its associated factors among female sex workers in Entebbe Municipality, Wakiso District

Abstract

Background: Hepatitis B is an important public health problem; although it is often asymptomatic initially, the long-term complications include cirrhosis and hepatic cancer, diseases that kill about a million people worldwide each year. Sexually Transmitted Infections (STIs) like hepatitis B are usually concentrated in core groups, such as female sex workers (FSWs), who have a high number of partners and receive poor health care. The Hepatitis B virus (HBV) is unique compared to other sexually transmitted diseases, because it can be prevented with the uptake of hepatitis B services which include hepatitis B screening for some at risk populations and general vaccination. Objective: To assess the Uptake of hepatitis B services and its associated factors among female sex workers in Entebbe municipality, Wakiso district. Method: This research essentially took on a descriptive cross sectional survey design. In this study the target population was female sex workers aged 18 years old and above in Entebbe Municipality. Mapping “hot spots” was done using purposive sampling technique in order to select the participants to take part in the study, considering the hot spots for FSWs from Entebbe Municipality. Respondents were recruited using the non-probability sampling method because it is appropriate for hard to reach populations including FSWs. The researcher chose to use, structured interviews to collect the required data from the female sex workers. The structured was used to collect data from respondents. Results: It was found that majority of the female sex workers had not taken up the hepatitis B services 108(71.5%), with the level of Hep B service uptake being 28.5% (43). The results showed that the female sex workers whose ages fell between 25 – 34 years were three times more likely to uptake hepatitis B services (OR = 3.3, CI = .220 - 40.949) and those between 18 – 24 years were twice more likely to uptake the services (OR = 2), the respondents who were single had higher odds of up taking hepatitis B services (OR = 3.265, CI = 0.227-22.569), and were those who had health insurance (OR = 2, CI = 0.045 – 14.896). The female sex workers who had been earlier Screened for cervical cancer before were three times more likely to uptake hepatitis B services (OR = 3.859, CI = 0.328 – 22.249) as well as those who usually sought health care services from govern health centers (OR = 3.551, CI – 0.573 – 22.023). Bivariate analysis for the relationships between psychosocial factors and uptake of hepatitis screening services showed that How supportive family/relatives are in getting Hepatitis B screening (p = 0.004), How supportive friends are in getting Hepatitis B screening (p = 0.002), = stigmatization (p = 0.008), View about Hepatitis B screening (p = 0.006), Belief that screening is the best way to prevent Hepatitis B (p = 0.001), View about Hepatitis B vaccination (p = 0.001), and the belief getting vaccinated after a negative screening test is the best way to prevent Hepatitis B (p = 0.010) had significant relationships with the uptake of hepatitis B services uptake. At health facility level, access to Hepatitis B services (p = 0.005), distance to the nearest health facility (p = 0.001), Any Hepatitis B services available at the nearest health facility (p = 0.002), Cost of Hepatitis B vaccination services (p = 0.001), and Waiting time for Hepatitis B services (p = 0.037) had significant relationships with the uptake of hepatitis B services. Conclusion: The uptake of hepatitis B services among female sex workers in Entebbe Municipality is generally low especially when it comes to hepatitis B screening services uptake. The uptake of these services among the FSW is influenced by factors at individual, psychosocial and at health system in that order. It is recommended that the ministry of health gives special attention in terms of outreach to marginalized groups such as commercial sex workers so that the Hep B screening services are brought closer to them given that some are stigmatized. Health education on the importance of Hep B screening and vaccination should also be intensified and especially extended to FWS.