Lifetime Abortion of Female Sex Workers in Iran: Findings of a National Bio-Behavioural Survey In 2010

Abstract

IntroductionUnintended pregnancies and abortion may be considered as occupational hazards for female sex workers (FSWs). As our understanding of contraceptive and abortion practices of Iranian FSWs is very limited, this study tries to assess the dynamics of contraception and abortion among this sub-population.MethodsThis survey was conducted in 2010, by recruiting 872 FSWs through facility-based sampling from 21 sites in 14 cities in Iran. Data were collected through face-to-face interviews using a pilot-tested standardized risk assessment questionnaire. We applied the logistic regression model to investigate the correlates of induced abortion among FSWs.ResultsOf the 863 participants with valid responses to the abortion variable, 35.3% (95% CI: 32.1–38.6) acknowledged ever induced abortion and the annual rate of abortion was estimated at 20.7 per 1000 women. Around 31.2% of FSWs reported no usual contraceptive use, 32.6% barrier method, 23.6% non-barrier modern contraception methods, and 12.5% dual protection. In our multivariable model, older age (Adjusted Odds Ratio (AOR) = 1.74, 95% Confidence Interval (CI): 1.02, 2.96), group sex (AOR = 1.92, 95% CI: 1.10, 3.35), history of travel for sex work (AOR = 1.55, 95% CI: 1.09, 2.20), sexual violence (AOR = 1.77, 95% CI: 1.25, 2.50), STIs in last year (AOR = 1.53, 95% CI: 1.09, 2.14), and accessing family planning services (AOR = 1.76, 95% CI: 1.24, 2.49) were significant predictors of lifetime abortion.ConclusionsThe reproductive health needs of Iranian FSWs are unmet and around one-third of FSWs reported induced abortion. Scaling-up comprehensive family planning services and empowering FSWs to have safer sex practices may help them to prevent unintended pregnancies and further risk of HIV transmission.

Consistent Condom Use with Paying and Nonpaying Partners among Female Sex Workers in Iran: Findings of a National Biobehavioral Survey

“…Collectively, our findings indicate the importance of reemphasizing consistent and correct safe sex practices for FSWs. Although the reproductive health needs of FSWs continue to be unmet in Iran, 17 further efforts should be made to improve FSWs' risk perception of HIV, safe sex negotiation skills, and access to prevention services. Developing studies to reach paying and nonpaying sex partners of FSWs is an urgent priority; populations who are currently overlooked in surveillance services in Iran but have a key role in increasing safe sex practices among FSWs.…”

“…Details of methodology and sampling strategies of the survey are described elsewhere. [16][17][18] In brief, participants were recruited from 21 sites in 14 cities by trained interviewers from a geographically representative sample of FSWs. The recruiting sites included specific centers catered toward vulnerable women (ie, FSWs, partners of PWIDs, and women who inject drugs).…”

Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin

“…Unsafe abortion highly contributes to MMR in developing countries [ 16 ]. In some studies, the proportion of unintended pregnancies occurring during sex work was around 90% [ 13 , 17 ] and lifetime abortion rate varies between 35 and 65% [ 18 – 21 ] among FSWs from low and middle-income countries. With the current available information, it is difficult to know if such abortions mostly occur prior to or after entry into sex work.…”

Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin

“…Unsafe abortion highly contributes to MMR in developing countries [16]. In some studies, the proportion of unintended pregnancies occurring during sex work was around 90% [13,17] and lifetime abortion rate varies between 35% and 65% [18][19][20][21] among FSWs from low and middle-income countries. With the current available information, it is difficult to know if such abortions mostly occur prior to or after entry into sex work.…”