ABSTRACT
Background and Aims
Female sex workers face substantial barriers to accessing healthcare services. We examined factors influencing preference for government versus non-government healthcare services among female sex workers in Bangladesh.
Methods
Three hundred and eighty-four female sex workers from the south-western region of Bangladesh were interviewed in this cross-sectional survey. Preferences and explanatory variables (demographics, income, abuse history, routine check-up engagement, etc.) were analyzed using χ
2 tests and multiple logistic regression (MLR) to identify independent predictors of government-facility preference.
Results
We recorded that about one-third (32.1%) of our participants preferred government services. Participants reporting a routine health check-up had over twice the odds of government-care preference (AOR = 2.72, 95% CI 1.41–5.24), whereas non-Muslims (AOR = 0.21, 95% CI 0.07–0.67) and those experiencing abuse (AOR = 0.35, 95% CI 0.16–0.73) were less likely to choose public facilities. Higher incomes decreased the likelihood of choosing government facilities (AOR = 0.23–0.30), while moderate household size (3–4 members; AOR = 2.41, 95% CI 1.11–5.23) and urban residence (AOR = 2.41, 95% CI 0.99–5.87) increased it.
Conclusion
We conclude that engagement with routine services, socioeconomic status, religion, and abuse experiences shaped the healthcare-seeking preferences for the female sex workers. Tailored interventions, including stigma-reduction training, outreach to minority groups, and NGO–public partnerships, are needed to improve government-facility utilization among this marginalized social group in Bangladesh.