High rates of Unintended Pregnancies among Young Women Sex Workers in
            Conflict-affected Northern Uganda: The Social Contexts of Brothels/Lodges and Substance
            Use

Duff, Patricia A.; Muzaaya, Godfrey; Muldoon, Katherine A.; Dobrer, Sabina; Akello, Monika; Birungi, Josephine; Shannon, Kate

doi:10.29063/ajrh2017/v21i2.8

Cited by 8 publications

(8 citation statements)

References 38 publications

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Section: Discussionmentioning

confidence: 99%

“…Another reproductive health problem of the participants was fear of unwanted pregnancy, which jeopardizes the physical, mental and social aspects of their reproductive health and its consequences affects the quality of life of the women, families, and society (Duff et al, 2017;Kheiriat et al, 2014;Madeiro & Diniz, 2015) Bostani, et al in 2018, Weldegebreal in Mumbasa in 2015, and Kilembe in Zimbabwe in 2019 reported that female sex workers were at high risk of sexual and reproductive health related mortality and morbidity, especially due to unwanted pregnancy, unsafe abortions, and STIs (Bostani et al, 2017;Kilembe et al, 2019;Weldegebreal et al, 2015). There were also several mentions of unwanted pregnancy, unsafe abortions, financial problems, stigma, and fear of unwanted pregnancy in the present research.…”

Section: Fearmentioning

confidence: 99%

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Reproductive Health Concerns of Women With High Risk Sexual Behaviors

et al. 2021

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Introduction Expansion of reproductive health services and addressing its different aspects in national and international levels is an important step towards ensuring family and public health. Female sex workers are a vulnerable population that are exposed to high risk sexual behaviors and increased incidence of co-morbid health problems. This study aims to identify the concerns of women with high risk sexual behaviors. Clarifying different aspects of reproductive health and its problems in female sex workers can assist relevant authorities to plan and intervene on reproductive health and to provide more effective solutions on this issue. Methods A qualitative study was conducted using a conventional content analysis approach. Snowball sampling was performed in 20 volunteer women with high risk sexual behaviors through in-depth semi-structured interviews conducted in drop-in centers, triangle centers, etc. The data were analyzed through conventional content analysis using the MAXQDA software. Results Five main categories and 13 subcategories emerged during the interviews. The main categories included violence, fear, and lack of knowledge, stigma, and psychological problems. Women with high risk sexual behaviors have several reproductive health concerns, including unwanted pregnancy, abortion, STIs (Sexually transmitted infections ), HIV, etc. In addition, different types of violence and threats against women, intimidation, objectification, stigma, unresponsiveness of counselling centers, patriarchal culture, gender inequality, etc. were observed in these women. Conclusion The study revealed that women in this study experienced deep problems of reproductive health and little attention is paid to them by authorities. Proper planning and appropriate solutions should be provided to solve the problems of these women and the society.

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Section: Discussionmentioning

confidence: 99%

Section: Fearmentioning

confidence: 99%

Reproductive Health Concerns of Women With High Risk Sexual Behaviors

et al. 2021

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“…18 There are similar findings in other countries. [19][20][21] The situation is partly driven by poor access to health services and criminalisation or restriction of abortions in some settings. Unplanned pregnancies may also add financial pressures and lead to increased risk-taking.…”

Section: Introductionmentioning

confidence: 99%

Values and preferences of contraceptive methods: a mixed-methods study among sex workers from diverse settings

Sibanda

Shapiro

Mathers

et al. 2021

Sexual and Reproductive Health Matters

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There is limited information on contraceptive values and preferences of sex workers. We conducted a mixed-method study to explore contraceptive values and preferences among sex workers. We conducted an online survey with individuals from 38 countries (n = 239), 6 focus group discussions (FGD, n = 68) in Zimbabwe, and 12 in-depth phone interviews (IDI) across 4 world regions, in June and July of 2019.Participants were asked about awareness of contraceptives, methods they had used in the past, and the determinants of their choices. Differences between respondents from high-, low-and middle-income countries were examined. Qualitative data were analysed thematically. Survey participants reported an awareness of modern contraceptive methods. FGDs found that younger women had lower awareness. Reports of condomless sex were common and modern contraceptive use was inconsistent. Determinants of contraceptive choices differed by setting according to results of the survey, FGD, and IDI. Regardless of country income level, determinants of contraceptive choices included ease of use, ease of access to a contraceptive method, and fewer side effects. Healthcare provider attitudes, availability of methods, and clinic schedules were important considerations. Most sex workers are aware of contraceptives, but barriers include male partners/clients, side effects, and health system factors such as access and clinic attitudes towards sex workers.

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“…Nevertheless, the high unmet need for modern contraception (39.0%) among women of reproductive age in Gulu district ( 4) is an indication that the family planning indicators may be worse among FSWs in the region. Moreover, FSWs in Uganda were noted to have high rates of unplanned pregnancies (5)(6)(7)(8) and post-abortion complications (8)(9)(10). These further suggest a big gap in LARC use among FSWs and threaten future fertility of FSWs who still desire to have children (11).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with use of long-acting reversible contraception among female sex workers operating in Gulu district, Northern Uganda – a cross-sectional study

Ouma

Tumwesigye

Abbo

et al. 2021

Preprint

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Background: Long-acting reversible contraception (LARC) are the most effective and reliable contraceptives for female sex workers (FSWs) and require periodic users’ involvement only at the time of application or re-application. However, information on LARC use among FSWs in Uganda is scarce. To fill this gap, we determined the prevalence of LARC use among FSWs and examined factors associated with LARC use among FSWs operating in Gulu district, Northern Uganda.Methods: Across-sectional study was conducted among 300 FSWs aged 18 years and above and operating in Gulu district. Semi-structured questionnaires were used to measure factors associated with the use of LARC: intrauterine device (IUD), Implants, and injectables. Data analyses were conducted using STATA 14.0 and restricted to 280 non-gravid adult FSWs aged 18-49 years who were not on permanent contraception method. To examine factors associated with LARC use, prevalence ratios (PR) with robust standard errors were computed using Poisson regression.Results: Among the participants, the mean age (SD, range) was 26.5 (5.9, 18 - 45) years, 53.2% never married, 66.1% reported consistent condom use independent of LARC, 58.9% had unintended pregnancy during a lifetime, 48.6% had at least one unintended pregnancy during sex work, and 37.4% had at least one induced abortion. The prevalence of LARC use was 58.6%; the majority were using Implants (48.2%), followed by injectables (42.7%), and IUDs (9.1%). Independent factors associated with LARC use included: longer duration of sex work [≥ two years] (adjusted PR=1.44, 95% CI: 1.03-2.02), higher parity [≥ two] (adjusted PR=1.13, 95% CI: 1.02-1.26), history of unintended pregnancy during sex work (adjusted PR=1.24 CI: 1.01-1.51), and being a brothel/lodge-based FSWs (adjusted PR=1.28, 95% CI: 1.01-1.63).Conclusions: There is a big gap in LARC use with only 58.6% of FSWs using LARC. LARC use was associated with longer duration of sex work, higher parity, history of sex work-related unintended pregnancy, and being a brothel/lodge-based FSW. Therefore, interventions to improve LARC use should intensively target the newly recruited FSWs, FSWs with low parity, and FSWs not based in brothels or lodges.

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High rates of Unintended Pregnancies among Young Women Sex Workers in Conflict-affected Northern Uganda: The Social Contexts of Brothels/Lodges and Substance Use

Cited by 8 publications

References 38 publications

Reproductive Health Concerns of Women With High Risk Sexual Behaviors

Reproductive Health Concerns of Women With High Risk Sexual Behaviors

Values and preferences of contraceptive methods: a mixed-methods study among sex workers from diverse settings

Factors associated with use of long-acting reversible contraception among female sex workers operating in Gulu district, Northern Uganda – a cross-sectional study

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