Author ORCID Identifier
0009-0000-4229-9459
Date of Award
Fall 11-21-2024
Degree Type
Closed Dissertation
Degree Name
Doctor of Public Health (DrPH)
Department
Public Health
First Advisor
Kimberley Freire, Ph.D.
Second Advisor
Shane Diekman, Ph.D.
Third Advisor
Sarah McCool, Ph.D.
Abstract
Introduction. This research explores the role of community-driven development in advancing human immunodeficiency virus (HIV) prevention, care, and treatment for male sex workers (MSW) and transgender female sex workers (TFSW) in Kenya, South Africa, and Thailand. Despite being at elevated risk for HIV, MSWs and TFSWs have historically received less attention in research, policy, and program development compared to female sex workers (FSW) and men who have sex with men (MSM). This gap in focus is particularly concerning given the stigma, discrimination, and criminalization that further marginalize MSWs and TFSWs, limiting their access to essential HIV-related services.
Methods. Community-based organizations (CBO) play a crucial role in reaching these populations by offering stigma-free, confidential, and culturally sensitive HIV services. This research aims to address the gaps in knowledge about how community-driven development can improve health outcomes for MSWs and TFSWs by examining CBO-led efforts across three countries with differing HIV epidemic contexts—Kenya, South Africa, and Thailand. Through qualitative interviews with key informants from 13 CBOs across these countries, the study investigates how community-driven approaches are being utilized to provide HIV services, the challenges faced by MSWs and TFSWs in accessing healthcare, and the innovative strategies employed by CBOs to overcome these barriers.
Results. Findings reveal that community-driven development is essential for providing tailored HIV services to MSWs and TFSWs, who often avoid traditional healthcare settings due to fear of discrimination. CBOs use peer educators, community outreach, and online platforms to engage these populations, particularly in urban and high-risk areas. The research also highlights critical challenges, including legal and policy barriers, limited funding, and the vulnerability of migrant sex workers, particularly in South Africa and Thailand.
Conclusion. The researcher concludes that scaling up community-driven development, ensuring sustainable funding, and implementing policy changes that support MSWs and TFSWs are vital for reducing HIV transmission and improving healthcare access. Recommendations are offered for strengthening CBO capacity and fostering greater collaboration between governments and local organizations to enhance HIV-related health outcomes for MSWs and TFSWs.
Recommended Citation
Williams-Singleton, Nickie, "The Role of Community-Driven Development in Advancing HIV Prevention, Care, and Treatment for Male Sex Workers and Transgender Female Sex Workers in Kenya, South Africa, and Thailand." Dissertation, Georgia State University, 2024.
https://scholarworks.gsu.edu/sph_diss/108
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