@article{8570727,
  abstract     = {{Objectives: To enhance uptake of sexual and reproductive health (SRH) services by female sex workers (FSWs), we conducted an implementation study in which we piloted and tested context-specific diagonal' interventions, combining vertical, targeted interventions with horizontally improved access to the general health services, in three cities in sub-Saharan Africa. 
Methods: We collected indicators of SRH service uptake through face-to-face interviews with approximately 400 FSWs, pre- and post-intervention, in Durban, South Africa; Tete, Mozambique; and Mombasa, Kenya, recruited by respondent-driven sampling. Changes in uptake were tested for their statistical significance using multivariate logistic regression models. 
Results: In all cities, overall uptake of services increased. Having used all services for contraception, STI care, HIV testing, HIV care, cervical cancer screening and sexual violence, if needed, increased from 12.5% to 41.5% in Durban, 25.0% to 40.1% in Tete and 44.9% to 69.1% in Mombasa. Across cities, the effect was greatest in having been tested for HIV in the past six months which increased from 40.9% to 83.2% in Durban, 56.0% to 76.6% in Tete and 70.9% to 87.6% in Mombasa. In Tete and Mombasa, rise in SRH service use was almost entirely due to a greater uptake of targeted services. Only in Durban was there additionally an increase in the utilisation of general health services. 
Conclusion: SRH service utilisation improved in the short-term in three different sub-Saharan African contexts, primarily through vertical, targeted components. The long-term effectiveness of diagonal approaches, in particular on the use of general, horizontal health services, needs further investigation.}},
  author       = {{Lafort, Yves and Greener, Letitia and Lessitala, Faustino and Chabeda, Sophie and Greener, Ross and Beksinska, Mags and Gichangi, Peter and Griffin, Sally and Smit, Jenni A and Chersich, Matthew and Delva, Wim}},
  issn         = {{1360-2276}},
  journal      = {{TROPICAL MEDICINE & INTERNATIONAL HEALTH}},
  keywords     = {{SOUTH-AFRICA,COTE-DIVOIRE,CARE,POPULATIONS,BURDEN,ACCESS,KENYA,INDIA,MOZAMBIQUE,NAVIGATION,female sex workers,sexual and reproductive health,HIV prevention and,care,care-seeking behaviour,sub-Saharan Africa}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{774--784}},
  title        = {{Effect of a 'diagonal' intervention on uptake of HIV and reproductive health services by female sex workers in three sub-Saharan African cities}},
  url          = {{http://doi.org/10.1111/tmi.13072}},
  volume       = {{23}},
  year         = {{2018}},
}

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