Contraceptive needs of female sex workers in Kenya – A cross-sectional study

Sutherland, Elizabeth; Alaii, Jane; Tsui, Sharon; Luchters, Stanley; Okal, Jerry; King'ola, Nzioke; Temmerman, Marleen; Janowitz, Barbara

doi:10.3109/13625187.2011.564683

Cited by 66 publications

(88 citation statements)

References 14 publications

(24 reference statements)

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“…Sex workers may state that they use condoms in response to this question, despite the fact that they use condoms only as an HIV or STI prevention measure with some partners. 14,16 Hence, to assess dual protection use among female sex workers, measures must account for the consistency of dual method use across partners, rather than relying solely on reported contraceptive methods, or on method use with the most recent partner. The HIV prevalence in Swaziland is among the highest in the world, with 32% of adults living with HIV.…”

Section: Dependent Variablesmentioning

confidence: 99%

Use of Dual Protection Among Female Sex Workers in Swaziland [

Yam

Mnisi²,

Mabuza³

et al. 2013

IPSRH

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Female sex workers are at high risk of both HIV infection and unintended pregnancy. Although programs and policies targeting female sex workers emphasize HIV prevention and condom promotion, they typically pay limited attention to the family planning needs of these women.Correct and consistent condom use is highly effective at preventing HIV and other STIs, but condoms are not the most effective contraceptive method.1 In contrast, nonbarrier modern contraceptive methods (such as oral contraceptives, injectables and sterilization) are highly effective at preventing pregnancy, but confer no protection against STIs. For protection against both unwanted pregnancy and STIs, one option is a dual method approach: consistent use of condoms in conjunction with a more effective nonbarrier method. However, for many women-particularly female sex workers, who have frequent sex with multiple partners-the use of two methods for every sex act may be burdensome and unrealistic. For these women, a more feasible dual protection strategy might be a singlemethod approach: consistent condom use alone. Most dual protection research has taken place in developed countries, where contraceptive prevalence is relatively high. The reported prevalence of dual method use among American women ranges from 7% to 38%. 2-7 A handful of studies on dual protection have been conducted in Sub-Saharan Africa, where both HIV and unwanted pregnancy are critical public health challenges. In South Africa and Botswana studies, dual method use at last sex ranged from 4% to 28%. [8][9][10][11] However, a limitation of most research on dual protection is the focus on method use at last sex, rather than consistency of simultaneous condom and other contraceptive use at each coital act. These "last sex" measures of dual method use may not reflect optimal dual protection against both pregnancy and disease.Little is known about the dual protection strategies employed by female sex workers, and measurement of their contraceptive behaviors is complicated by the fact that their condom use varies across partners. Specifically, female sex workers use condoms less consistently with more intimate, noncommercial partners than with paying clients. [12][13][14] In addition, their reported condom use at last sex or with their most recent partner likely will not accu-

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Section: Dependent Variablesmentioning

confidence: 99%

Use of Dual Protection Among Female Sex Workers in Swaziland [

Yam

Mnisi²,

Mabuza³

et al. 2013

IPSRH

View full text Add to dashboard Cite

show abstract

“…We should also note that the calculation used for unmet need is not directly comparable with the calculations from other studies, as the definitions and measurements of fertility desires, method use and consistency of condom use vary among studies. 9,10,14 As we explained earlier, our measure of unmet need used definitions of fertility desires and consistent condom use that were stricter than those typically used in other studies.…”

Section: Health Care Experiences and Preferencesmentioning

confidence: 99%

“…Female sex workers may use condoms inconsistently because they lack the autonomy to insist on condom use with husbands, boyfriends or other steady partners, agree to have condomless sex with clients who will pay extra, are unable to negotiate condom use with clients and or are forced to have sex. [6][7][8][9][10][11] Using condoms inconsistently, rather than every time, increases the risk not only of acquiring an STI, but also of pregnancy if a second contraceptive method is not used.…”

mentioning

confidence: 99%

Understanding the Broader Sexual and Reproductive Health Needs of Female Sex Workers in Dhaka, Bangladesh

Katz

McDowell²,

Green³

et al. 2015

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“…[64][65][66][67][68] Yet, fertility-related evidence has focused predominantly on the incidence of pregnancy among sex workers and their unmet contraceptive needs. [69][70][71] Continued efforts to integrate emergency contraception into sex worker-friendly services, and measurement of the impact of these services on unsafe abortions would help to expand the evidence base. 72 Even with calls for better integration of sexual and reproductive health care services into HIV prevention programmes for female sex workers, limited implementation results are available exploring the uptake and impact of attempts to promote integration.…”

Section: Resultsmentioning

confidence: 99%

“…63,78,79 Abortion is common among sex workers, though less is known about the safety of abortions or access to post-abortion care. 70,[80][81][82] Existing information suggests that many abortions are unsafe and complications common. [83][84][85] Legal barriers and criminalization of abortion and sex work in many settings discourage safe abortions and preventive measures, magnifying risk and decreasing access and/or engagement in appropriate care.…”

Section: Resultsmentioning

confidence: 99%

Fertility-related research needs among women at the margins

Schwartz¹,

Baral

2015

Reproductive Health Matters

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Fertility-related research encompasses fertility intentions, preconception care, research amongst pregnant women, and post-partum outcomes of mothers and children. However, some women remain underrepresented within this domain of study. Women frequently missing within fertility-related research include those who are already the most vulnerable to health disparities, including female sex workers, lesbian, gay, bisexual, and transgender women, women living with HIV, and women who use drugs. Yet characterization of the needs of these women is important, given their unique fertility-related concerns, including risks and barriers to care emanating from social stigmas and discrimination. This synthesis provides an overview of fertility-related evidence, highlighting where there are clear research gaps among marginalized women and the potential implications of these data shortfalls. Overall, research among marginalized women to date has addressed pregnancy prevention and in some cases fertility intentions, but the majority of studies have focused on postconception pregnancy safety and the well-being of the child. However, among female sex workers specifically, data on pregnancy safety and the well-being of the child are largely unavailable. Within each marginalized group, preconception care and effectiveness of conception methods are consistently understudied. Ultimately, the absence of epidemiologic, clinical and programmatic evidence limits the availability and quality of reproductive health services for all women and prevents social action to address these gaps.

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Contraceptive needs of female sex workers in Kenya – A cross-sectional study

Cited by 66 publications

References 14 publications

Use of Dual Protection Among Female Sex Workers in Swaziland [

Use of Dual Protection Among Female Sex Workers in Swaziland [

Understanding the Broader Sexual and Reproductive Health Needs of Female Sex Workers in Dhaka, Bangladesh

Fertility-related research needs among women at the margins

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