Single Mothers and Female Sex Workers in Zambia Have Similar Risk Profiles

Kilembe, William; Inambao, Mubiana; Sharkey, Tyronza; Wall, Kristin M.; Parker, Rachel; Himukumbwa, Constance; Tichacek, Amanda; Malama, Kalonde; Visoiu, Ana-Maria; Price, Matt A.; Chomba, Elwyn; Allen, Susan

doi:10.1089/aid.2019.0013

Cited by 11 publications

(15 citation statements)

References 48 publications

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“…An established prospective cohort of HIV-uninfected high-risk women (HRW) in Lusaka and Ndola, Zambia was examined. 11–13 The women included were either FSWs or single mothers with children under the age of five (SM) referred to the Zambia-Emory HIV Research Project (ZEHRP) from local post-natal clinics or invited from community outreach at sex work hot spots.…”

Section: Methodsmentioning

confidence: 99%

Sociodemographic factors and STIs associated withChlamydia trachomatisandNeisseria gonorrhoeaeinfections in Zambian female sex workers and single mothers

et al. 2020

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Sexually transmitted infections (STIs) in women caused by Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG) are epidemiologically distinct. In this study, associations with sociodemographic and clinical risk factors are explored separately for CT and NG. Multivariate logistic regression (MLR) models quantify associations between potential CT and/or NG risk factors within a cross-sectional study of high-risk women in two Zambian cities, Lusaka and Ndola. CT was associated with living in Lusaka, younger age, and literacy. Long-acting reversible contraception (LARC) was predictive of CT in Ndola, but protective in Lusaka. In Lusaka only, CT was associated with lower education and reported unprotected sex. NG was associated with younger age, lower education, concurrent Trichomonas vaginalis, bacterial vaginosis, and incident syphilis infection. Signs and symptoms were rare and not associated with either infection. CT was more prevalent, nearly 11%, compared to NG, 6.8%. The higher prevalence of CT could explain the lack of association with other STIs. The associations observed with NG could be the result of high-risk sexual networks or lack of protective immunity. Risk factors for CT and NG are distinct and may differ geographically, which should be considered when developing diagnostic tools or guiding presumptive treatment in specific populations.

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Section: Methodsmentioning

confidence: 99%

Sociodemographic factors and STIs associated withChlamydia trachomatisandNeisseria gonorrhoeaeinfections in Zambian female sex workers and single mothers

et al. 2020

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“…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: 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%

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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“…Population. Data are from a cross-sectional study conducted from September 2016 to January 2019 adding CT/NG testing in a cohort of HIV-uninfected women in Lusaka and Ndola, Zambia (5). Participants included FSW recruited from community sex work hot spots and SM referred to the Zambia-Emory HIV Research Project (ZEHRP) by local postnatal care providers.…”

Section: Methodsmentioning

confidence: 99%

A Population-Specific Optimized GeneXpert Pooling Algorithm for Chlamydia trachomatis and Neisseria gonorrhoeae To Reduce Cost of Molecular Sexually Transmitted Infection Screening in Resource-Limited Settings

Connolly

Kilembe²,

Inambao³

et al. 2020

J Clin Microbiol

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Background: The sexually transmitted infections (STIs) chlamydia (CT) and gonorrhea (NG) are often asymptomatic in women and undetected by syndromic management, leading to complications such as pelvic inflammatory disease, infertility, and ectopic pregnancy. Molecular testing, such as the GeneXpert CT/NG assay, is highly sensitive, but cost restraints preclude implementation of these technologies in resource-limited settings. Pooled testing is one strategy to reduce the cost-per-sample, but the extent of savings depends on disease prevalence. Methods: The current study describes a pooling strategy based on identification of sociodemographic and laboratory factors associated with CT/NG prevalence in a high-risk cohort of Zambian female sex workers and single mothers conducted from 2016-2019. Results: Factors associated with testing positive for CT/NG via logistic regression modeling included city, younger age, lower education, long-acting reversible contraception usage, Trichomonas vaginalis infection, bacterial vaginosis, and incident syphilis infection. Based on these factors, the study population was stratified into high, intermediate, and low prevalence sub-groups and tested accordingly: individually, pools of 3, or pools of 4, respectively. The cost-per-sample was reduced from US$18 to as low as US$9.43 in the low prevalence sub-group. Conclusions: The checklist tool and pooling approach described can be used in a variety of treatment algorithms to lower the cost-per-sample and increase access to molecular STI screening. This is particularly valuable in resource-limited settings to detect and treat asymptomatic CT/NG infections missed by traditional syndromic management.

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Single Mothers and Female Sex Workers in Zambia Have Similar Risk Profiles

Cited by 11 publications

References 48 publications

Sociodemographic factors and STIs associated withChlamydia trachomatisandNeisseria gonorrhoeaeinfections in Zambian female sex workers and single mothers

Sociodemographic factors and STIs associated withChlamydia trachomatisandNeisseria gonorrhoeaeinfections in Zambian female sex workers and single mothers

Reproductive Health Concerns of Women With High Risk Sexual Behaviors

A Population-Specific Optimized GeneXpert Pooling Algorithm for Chlamydia trachomatis and Neisseria gonorrhoeae To Reduce Cost of Molecular Sexually Transmitted Infection Screening in Resource-Limited Settings

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