War-Related Abduction and History of Incarceration Linked to High Burden of HIV Among Female Sex Workers in Conflict-Affected Northern Uganda

Abstract Background Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. Methods We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. Results Lifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20–6.20]), ever incarceration (AOR 5.06 [2.48–10.28]), and ever group sex (AOR 2.44 [1.21–4.92]). Conclusions Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.

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Identifying Barriers to Condom Use Among Female Sex Workers: a Systematic Review and Meta-analysis

10.21203/rs.3.rs-48093/v1 ◽

2020 ◽

Author(s):

Tahereh Omidi ◽

Maryam Mohammadian-khoshnoud ◽

Younes Mohammadi

Keyword(s):

Sexual Abuse ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Meta Analysis ◽

Sex Worker ◽

Female Sex ◽

History Of ◽

Hiv Risk Perception ◽

History Of Violence

Abstract Background: Many studies have shown a lot of factors which are as barriers to the condom use among female sex workers (FSWs). However, there is not a comprehensive study to report the number and magnitude of these barriers. This study aimed to resolve this gap by comprehensive systematic review and meta-analysis. Methods: We have searched the electronic databases include Web of Science, PubMed, and Scopus until September 2019. For each database we formulated a separate search strategy using keywords such as “condom use” and “sex worker” and the related synonyms. Epidemiological epidemiology addressed the factors associated with unprotected sex for the female sex worker. The heterogeneity across studies and probability of publication bias was investigated by I2 statistic and Begg's and Egger's tests respectively. The pooled effect size were expressed as odds ratio (OR) with 95% confidence intervals (CI) using a random-effects model.Results: Out of 5854 studies obtained in initial search, 35 studies with sample size 14218 participants had eligibility criteria which were included in the final analysis. Ten factors include marital status, alcohol use, history of violence, history of sexual abuse, history of STIs, STIs knowledge, HIV risk perception, drug use, knowledge about the condom use, condom use self-efficacy were identified in those studies. History of sexual abuse with OR=1.87 and the knowledge on AIDS with OR=1.07 had the strongest association and weakest association with condom use respectively. Conclusion: Many factors with different degrees of association influence on the condom use among female sex workers. However, history of sexual abuse, a history of violence, and HIV risk perception were considered as the major determinants of the condom use. The structural interventions, policy change and empowerment of female sex workers are recommended to increase consistent condom use in FSWs.

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High Burden of Prevalent and Recently Acquired HIV among Female Sex Workers and Female HIV Voluntary Testing Center Clients in Kigali, Rwanda

PLoS ONE ◽

10.1371/journal.pone.0024321 ◽

2011 ◽

Vol 6 (9) ◽

pp. e24321 ◽

Cited By ~ 20

Author(s):

Sarah L. Braunstein ◽

Chantal M. Ingabire ◽

Eveline Geubbels ◽

Joseph Vyankandondera ◽

Marie-Michèle Umulisa ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

High Burden ◽

Female Sex ◽

Voluntary Testing ◽

Testing Center

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Interpersonal and structural contexts of intimate partner violence among female sex workers in conflict-affected northern Uganda

Women & Health ◽

10.1080/03630242.2017.1342742 ◽

2017 ◽

Vol 58 (7) ◽

pp. 759-773 ◽

Cited By ~ 4

Author(s):

Margaret Erickson ◽

Shira M. Goldenberg ◽

Aditi Master ◽

Godfrey Muzaaya ◽

Monica Akello ◽

...

Keyword(s):

Intimate Partner Violence ◽

Sex Workers ◽

Partner Violence ◽

Female Sex Workers ◽

Intimate Partner ◽

Northern Uganda ◽

Female Sex

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Unmet contraceptives needs among Female Sex Workers (FSWs) in semi urban Blantyre, Malawi

10.21203/rs.3.rs-34458/v2 ◽

2020 ◽

Author(s):

Donatien Twizelimana ◽

Adamson S Muula

Keyword(s):

Side Effects ◽

Sex Workers ◽

Female Sex Workers ◽

Unmet Needs ◽

Outcome Variable ◽

Categorical Variables ◽

Care Providers ◽

Steady Partner ◽

Female Sex ◽

History Of

Abstract Background: Research has paid limited attention to understanding factors that are associated with unmet contraceptives needs among female sex workers. In order to fill this knowledge gap, we estimated the prevalence of unmet contraceptives needs and examined associated factors among FSWs in semi urban Blantyre, Malawi. Methods:. We used systematic sampling to recruit 290 female sex workers in semi urban Blantyre between February and March 2019. In this cross sectional study, we used questionnaire interviews to collect quantitative data. We calculated the mean and standard deviation for continuous variables and proportions for categorical variables to describe the data. Logistic regression analysis was used to investigate the association between unmet needs (the outcome variable) and explanatory variables such as: having a steady partner, fear of contraceptives’ side effects and having a history of sexually transmitted infections. Results: Out of the 290 study participants 102 (35.2%) reported unmet needs for contraceptives. The following factors were significantly associated with unmet contraceptives needs in multivariate analysis: female sex workers’ history of physical and sexual violence by clients [OR 3.38, 95% CI (1.10, 10.43)], p<0.03, participants with a steady partner [OR 3.28, 95% CI (1.89, 5.68)], p<0.001, and participants who feared side effects of contraceptives [OR 2.99, 95% CI (1.73, 5.20)], p<0.001. Conclusion: Reproductive Health services should address barriers to contraceptives use for instance: violence by female sex workers’ clients, fear and misinformation on contraceptives. There is need to improve awareness of contraceptives. Specific health promotion interventions on female sex workers engaged in a steady partnership are recommended. It is important to enhance the knowledge, attitudes, and counseling skills of health care providers in order to address unmet contraceptives needs among female sex workers in semi-urban Blantyre.

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

10.21203/rs.3.rs-275872/v1 ◽

2021 ◽

Author(s):

Simple Ouma ◽

Nazarius Mbona Tumwesigye ◽

Catherine Abbo ◽

Rawlance Ndejjo

Keyword(s):

Sex Work ◽

Unintended Pregnancy ◽

Sex Workers ◽

Female Sex Workers ◽

Northern Uganda ◽

Sectional Study ◽

Factors Associated ◽

History Of ◽

Gulu District ◽

Long Acting

Abstract 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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Natural history of Mycoplasma genitalium Infection in a Cohort of Female Sex Workers in Kampala, Uganda

Sexually Transmitted Diseases ◽

10.1097/olq.0b013e31828bfccf ◽

2013 ◽

Vol 40 (5) ◽

pp. 422-427 ◽

Cited By ~ 38

Author(s):

Judith Vandepitte ◽

Helen A. Weiss ◽

Nassim Kyakuwa ◽

Susan Nakubulwa ◽

Etienne Muller ◽

...

Keyword(s):

Natural History ◽

Sex Workers ◽

Female Sex Workers ◽

Mycoplasma Genitalium ◽

Female Sex ◽

History Of

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Client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-046894 ◽

2021 ◽

Vol 11 (9) ◽

pp. e046894

Author(s):

Simple Ouma ◽

Rawlance Ndejjo ◽

Catherine Abbo ◽

Nazarius M Tumwesigye

Keyword(s):

Low Income ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Hiv Positive ◽

Northern Uganda ◽

Gender Based Violence ◽

Cross Sectional ◽

Female Sex ◽

Gender Based

Study objectiveTo determine the prevalence and associated factors of client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda.Design and settingsWe conducted a cross-sectional study among female sex workers in Gulu district in conflict-affected Northern Uganda.ParticipantsThe study participants included 300 female sex workers aged 18+ years. The participants were selected using simple random sampling from a database of female sex workers maintained at a national non-governmental organisation in Gulu.Outcome measureThe outcome measure was self-reported exposure to client-perpetrated gender-based violence.MethodsWe used a pretested semistructured questionnaire to collect data on sociodemographic characteristics, sex work-related characteristics, alcohol use, illicit drug use, HIV status and self-reported exposure to client-perpetrated gender-based violence. Then, data were entered into Epi Info V.7 and analysed using Stata V.14.0.ResultsAmong participants, 61.0% reported client-perpetrated gender-based violence. Economic (58.7%) and emotional (52.0%) violence were the most common forms of client-perpetrated gender-based violence in this population. Independently, being: street-based (adjusted OR=9.66, 95% CI 2.78 to 33.5), mobile (adjusted OR=3.21, 95% CI 1.83 to 5.64), HIV-positive (adjusted OR=1.90, 95% CI 1.09 to 3.31) and a low-income earner (<USh200 000 monthly) (adjusted OR=2.26, 95% CI 1.18 to 4.30) were positively associated with exposure to client-perpetrated gender-based violence.ConclusionsThere is a high prevalence of client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda. Furthermore, female sex workers who were street-based, mobile, HIV-positive and low-income earners were more likely to experience client-perpetrated gender-based violence. The ministry of health and the development partners need to provide targeted public health interventions to prevent and manage the rampant gender-based violence among this underserved population.

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