BackgroundFemale sex workers have been disproportionately affected with HIV and anal sexual experience elevate their vulnerability. Anal intercourse has more risk of HIV transmission than vaginal intercourse for receptors that coupled with low condom and proper lubricant use behavior during anal sex. Besides majority of them did not understand HIV transmission risk of anal intercourse. In Ethiopia, studies on anal sexual experience is almost none existent, so the purpose of this study is to explored anal sexual experience and HIV transmission risk awareness among female sex worker in Dire Dawa, Eastern Ethiopia.MethodQualitative study with thematic analysis approach was conducted among 18 female sex workers and recruitment of study participants performed until saturation of information. The principal investigator conducted in-depth interviews using local language (Amharic) and it was recorded on audio recorder. Tape recorded data was transcribed and translated to English and entered into open code version 3.4 for coding and theme identification. Data collection conducted simultaneously with data analysis.ResultFemale sex workers practiced anal sex for different themes like financial influence, coercion, intentionally, peer pressure and as a sign of intimacy and love. Coercion, negative attitudes, poor awareness about HIV transmission risks of anal sex and protection capacity of condom and proper lubricants are the identified themes for not using condom and proper lubricants during anal sex by female sex workers. Inaccessibility and unavailability of health services for issues related to anal sex was the core reason for female sex workers’ misperception and risk anal sexual experience.ConclusionFemale sex workers practiced anal sex without risk reduction approaches and they did not understand exacerbated risk of anal sex to HIV transmission. Stakeholders including ministry of health need to incorporate potential awareness raising tasks and programs about risk of anal sex and methods of risk reduction for female sex workers.Electronic supplementary materialThe online version of this article (doi:10.1186/s41256-017-0047-6) contains supplementary material, which is available to authorized users.

Background: Commercial sex work exposed women to countless risks and exit is recommended as an essential strategy to tackle those risks. Intention to exit can predict women’s actual exit potential from commercial sex work. Therefore, the purpose of the study was to explore intention, barriers and facilitating situations to exit from commercial sex work among female sex workers in Dire Dawa, Ethiopia. Method: We conducted qualitative research among 18 female sex workers using in-depth interviews. Once data was collected with the local language, we transcribed the recorded data and translated to English before exporting to ATLASti7 to facilitate the data analysis process. We used respondent-driven sampling to recruit study participants. We implemented the inductive thematic analysis approach. Result and discussion: Women had a strong intention to exit from commercial sex work. Although women intended to give up on commercial sex work, they needed to pass barriers like financial insecurity, social stigma and discrimination, skill gap, lack of support and poor education status before they successfully exit. Their demand for minimal financial supports to open a private business and strong motivation are opportunities for a successful exit from commercial sex work. Conclusion: Women had a strong intention to exit from commercial sex work though they demanded support from others. Therefore, government and other stakeholders need to provide comprehensive support to commercial sex workers like financial support, fill skill gap and improve poor saving habit through training and establish functioning rehabilitation centers for drug addict women.

BackgroundHuman Immunodeficiency Virus greatly affects young peoples in developing countries, of which sexual transmission is the major route including vaginal, oral and anal sex. Understanding the full range of sexual behavior among young people, especially oral and anal sexual experience is very crucial to design appropriate intervention strategies. This study was to assess oral and anal sexual experience and associated factors among preparatory school youths in Dire Dawa city, Eastern Ethiopia.MethodsSchool based cross sectional study was conducted among 1067 school youths attending preparatory school. Systematic random sampling method was used to select study participants. Data were collected using self-administered questionnaire and entered in to Epi-data version 3.3.1 and exported to SPSS 20 for analysis. Descriptive and bivariate logistic regression was done. Variables in bivariate analysis with P< 0.25 were entered to multiple bivariate logistic regression analysis to determine predictor variables. P < 0.05 was declared as statistically significance and AOR with 95% CI used to assess strength of association.ResultsThe proportion of youths who reported having oral sex was 9% (88) and that of anal sex was 6.7% (66). Having multiple sexual partners was reported by 65.8% and 56.5% of youths who ever engaged in oral and anal sex respectively. From those who ever engaged to oral sex and anal sex 15.9% and 34.8% consistently used condom respectively. Oral sex practice was significantly associated with intimate partner ever engaged to oral sex practice (AOR = 4.53, 95% CI: 2.26–9.05), ever engaged to vaginal sex (AOR = 16.38, 95% CI: 7.22–37.19), older age (20-24years) (AOR = 2.45, 95% CI: 1.24–4.86), ever drinking alcohol (AOR = 2.11,95% CI:1.02–4.34), and ever smoke shisha (AOR = 2.85,95% CI:1.4–5.83). Similarly anal sex experience was significantly associated with intimate partner ever engaged to anal sex (AOR = 5.34, 95% CI: 4.2–26.98), ever engaged to vaginal sex (AOR = 10.64, 95% CI: 2.39–11.9), ever watching pornographic movies (AOR = 3.86, 95% CI: 1.45–10.29) and parental monitoring of youth’s sexual behavior (AOR = 2.63, 95% CI: 1.12–6.19).ConclusionsSignificant proportion of youths had engaged in oral and anal sexual practice and multiple sexual partners were common among youths for oral and anal sex. In the contrary consistent condom use was very poor. A combination of sexual health education intervention strategies should be implemented at family, school and community level.

Unmet need for family planning is a major problem in developing countries. Millions of women want to delay or avoid pregnancy but are not using Contraception. Addressing the unmet need for family planning provides an opportunity for policymakers to respond to existing choice problems. Simultaneously improving maternal and child health, slowing the rate of population growth, and contributing to the achievement of national goals. This study aimed to determine the pooled Magnitude and determinants of unmet need for family planning in Ethiopia. Ten articles with 19312 study participants were identified through electronic search of reputable databases: Google Scholar, PubMed, Cochrane library, MIDLINE, EMBASE, and Ovid Maternity and Infant Care Databases. 10 studies were selected based on a comprehensive list of inclusion and exclusion criteria. The analysis was done by using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used and a random effect model was also used to estimate the pooled prevalence of perinatal mortality rate. The pooled prevalence of the unmet need of modern family planning among reproductive-age women in Ethiopia was 19.99,95% CI(16.53,23.45).Age at first marriage less than 18, OR = 1.37, 95 CI :( 1.04–1.18),discussion with husbands, OR = 0.24, 95%CI :( 0.12–0.49), having two and less children OR = 0.49,95CI:(0.35–0.67), illiterate partner OR = 3.61, 95 %( 2.63–4.95), good attitude of partner OR = 0.11,95% CI:(0.05–0.26), history of discussion with health care worker OR = 0.31,95%CI: (0.14–0.68), a poor knowledge OR = 3.15,95% CI:(1.75–5.69) were significantly associated with unmet need for family planning. Unmet need for planning in Ethiopia is high as compared to world unmet need according to the United Nations World family planning report of 2017 which states one in ten reproductive age women have an unmet need for family planning but this study revealed one in five the same age group women had an unmet need for it. Early marriage, women’s discussion with husbands and health care workers about family planning, having children greater than two, education status and attitudes of husband, and knowledge of women about family planning were significantly associated with unmet need for family planning. So great effort is needed from all stakeholders to involve males in family planning decisions, alleviate early marriages, and structured health education interventions for both husbands and women to reduce the unmet need for family planning.