Abstract
BackgroundWorldwide, more than 1 million Sexually Transmitted Infections (STIs) are acquired every day and female adolescents aged 10 to 19 years are almost twice more susceptible to STIs than boys of the same age. The highest STI prevalence has been reported among key populations such as Female Sex Workers (FSWs) and fisher folk. This study investigated the factors influencing uptake of sexually transmitted infections screening among Adolescent Female sex Workers (AFSWs) in Mukono district, Uganda.MethodsIn this cross-sectional descriptive and analytical study, a total of 355 AFSWs based on the streets, bars, lodges, hotels, brothels, landing sites and other entertainment places in Mukono district were recruited using snowball sampling. Data was collected using pre-tested semi-structured questionnaires through face to face interviews with the help of trained research assistants. Data collected was entered into Epi-Data and then exported to SPSS for analysis. Analysis was done at three levels; Univariate for descriptive summary, Bivariate to test for possible association between each independent variable and the outcome variable, and Multivariate logistic regression to control for possible confounding effects of the independent variables. Chi square (χ2) test was done and p value 0.05 used to determine the association.ResultsThis study found that uptake of STIs screening among AFSWs was 32.1%. AFSWs who reported that STI screening wasn’t embarrassing were 3 times more likely to take-up STI screening than those who said uptake of STI screening was embarrassing (PR = 3.45, 95%CI = 1.96–6.09, P = < 0.001). AFSWs who reported that STI screening wasn’t painful were 5 times more likely to take-up STI screening than those who said uptake of STI screening was painful (PR = 5.45, 95%CI = 2.78–10.66, P = < 0.001).ConclusionSTIs screening rate among AFSWs in Mukono district was at 32.1%. Individual factors (attitude) and health facility factors were found to be the real influencers of uptake of STI screening among AFSWs in Mukono district. We, therefore, recommend that government scales up provision of sexually transmitted infection screening to even cater for high risk and vulnerable groups to facilitate and increase access to STI screening.Plain English summarySexually Transmitted Infections (STIs) refer to conditions caused by pathogens that can be acquired and transmitted through unprotected sexual intercourse such as cervical cancer, candida, HIV. Because majority of STIs are asymptomatic, screening uptake is of paramount importance for early detection followed by prompt treatment among high risk vulnerable groups such as Adolescent Female Sex Workers (AFSWs).Adolescence is a transitional phase of growth and development between childhood and adulthood and an adolescent is any person between ages 10 and 19. Sex work is the exchange of money, goods or services for sex and he who practices sex work is a sex worker. Quite a number of reasons such as age, peer pressure and others may explain why adolescents engage in immoral behaviors including sex work. In this STI screening uptake study, pre-tested semi-structured questionnaires were used to collect data from respondents on what was influencing their uptake of STI screening. Of the 355 respondents, majority 241 had never screened for STIs and 114 had screened. The research priorities identified were individual factors (attitude) and health facility factors as real influencers of uptake of STI screening among AFSWs in Mukono district.In conclusion, AFSWs require information related to STIs and its screening. Information dissemination can be intensified at clinical and non-clinical sites to increase awareness and improve accessibility to STI screening experience among high risk vulnerable groups in Mukono district, hence reduce the prevalence among AFSWs, avert the risk of complications and eliminate sustained transmission in the community.
Crimes Against Morality: Unintended Consequences of Criminalizing Sex Work*