Multiple Barriers to Utilization of Drug Abuse Treatment by Female Street Sex Workers in Nigeria

This study investigates barriers to utilization of drug abuse treatment by female street sex workers in Nigeria. Twenty-seven (n = 27) street sex workers were recruited through venue-based snow-ball sampling. In-depth, individual interviews were conducted, and transcripts were subjected to thematic, inductive and data-driven analysis. Sex workers use psychoactive drugs to manage the hazards of street sex work, including guilt, stigma, and violence. While a few denied drug-related harms, doubted treatment efficacy and evinced self-efficacy in managing drug problems, the majority of sex workers recognized drug-related harms and the need for treatment. Inadequate information on services, financial and time cost of treatment, fear of police arrest, stigma and lack of male partner support posed as barriers to drug abuse treatment. Social and structural barriers to treatment utilization violate sex workers' rights to health and exacerbate drug-related harms. Findings highlight the need for changes in policy and societal perceptions of sex work, and multi-level, rights-based interventions to remove barriers to drug abuse treatment for female street sex workers.