Female sex workers and access to social and health services in Catalonia: Influence of region of origin and place of work.

The objectives of the study were to describe the use of social and health services (SHS) of female sex workers (FSW) in Catalonia according to place of work and region of origin, and explore the barriers these women encountered when accessing these services. Quantitative and qualitative methods were combined. A questionnaire-based survey (n = 400) was conducted from October 2009 to January 2010, and complemented by focus group discussions technique (n = 23). More than 60% of FSW had used health services (HS) in the last 6 months (no differences by context of work and region of origin). Nevertheless, there were differences in the characteristics of health resources used. Although all women in clubs contracted the private HS provided by the club itself, they were those who least benefited from social services (SS), in particular Eastern-Europe women (24.6% in the last 6 months). The stigma and discrimination that FSW women suffer were one of the main barriers to access SHS. Women from Eastern Europe who worked in clubs were the most isolated and vulnerable women. Access to the public health system must continue to be provided for all FSW, assuring confidentiality and diminishing the burden associated with discrimination which they generally feel.