Prevalence and factors associated with major depression among female sex workers in post-conflict Gulu district: a cross-sectional study

Abstract Background Female sex workers operating in conflict-affected settings could be at a much greater risk of major depression. However, the epidemiology of major depression in this population remains understudied. We aimed to determine the prevalence and the factors associated with major depression among FSWs in the post-conflict Gulu district in Northern Uganda. Methods We conducted a cross-sectional study among 300 randomly selected adult female sex workers in Gulu. We utilized a pre-tested semi-structured questionnaire, embedded with MINI 7.0.0, to gather information from each participant through face-to-face interviews. We collected data on socio-demographic characteristics, sex-work-related characteristics, alcohol and drug use, HIV status, and major depression. Then, data were entered into EPI INFO 7 and analyzed using logistic regression with the aid of STATA 14.0. Results The mean age (SD) of the study participants was 26.4 (± 6) years, 57.7% attained primary education, 51.7% never married, and 42.1% were living with HIV. The prevalence of major depression among FSWs in the district was 47.7%. In addition, the majority of the FSWs with major depression (91.0%) had either severe (50.4%) or moderate (40.6%) depressive symptoms. Independently, life stress (adjusted OR = 10.8, 95%CI: 5.67–20.57), living with HIV (adjusted OR = 2.25, 95%CI: 1.25–4.05), verbal abuse (adjusted OR = 2.27, 95%CI: 1.27–4.08), and older age (adjusted OR = 1.06, 95%CI: 1.01–1.12) all showed positive associations with major depression. Conversely, provision of sexual services from clients’ homes (adjusted OR = 0.50, 95%CI: 0.25–0.97), use of a non-barrier modern family planning method (adjusted OR = 0.44, 95%CI: 0.24–0.82), and daily intake of alcohol (adjusted OR = 0.50, 95%CI: 0.28–0.88) all showed negative associations with major depression. Conclusions There is a high prevalence of major depression among female sex workers in post-conflict Gulu. The high prevalence of major depression underscores the need for government and development partners to urgently and adequately address the mental health needs of female sex workers.

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Prevalence and Factors Associated with Major Depression Among Female Sex Workers in Post-Conflict Gulu District: A Cross-Sectional Study

10.21203/rs.3.rs-50097/v1 ◽

2020 ◽

Author(s):

Ouma Simple ◽

Nazarius Mbona Tumwesigye ◽

Rawlance Ndejjo ◽

Catherine Abbo

Keyword(s):

Major Depression ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Female Sex ◽

Post Conflict ◽

Gulu District ◽

Living With Hiv

Abstract Background: Depression is the world’s leading cause of disability and a major contributor to the overall global burden of disease. Female sex workers operating in conflict-affected settings could be more prone to depression, yet the prevalence and factors associated with depression among this special population remain inadequately addressed. This study thus aimed to determine the prevalence and factors associated with major depression among female sex workers in post-conflict Gulu district. Methods: This cross-sectional study was conducted among 300 randomly selected female sex workers in Gulu district between March and June 2020. Possible factors associated with depression were assessed using pre-tested semi-structured questionnaire and participants assessed for major depression using Mini-International Neuropsychiatric Interview (MINI) version 7.0.0. We utilized STATA 14.0 for univariate, bivariate and multivariate data analyses.Results: The mean age of study participants was 26.4 years (SD = 6), 57.7% attained primary education, 51.7% never married and 42.1% were living with HIV. Almost half (47.7%) of the participants had major depression, of whom half (50.4%) had severe depression and one-thirds (34.3%) had suicidal ideation. At multivariate level, factors that showed positive association with major depression were: psychological stressor (aOR = 11.0, 95%CI: 5.77-20.86), living with HIV (aOR= 2.32, 95%CI: 1.29-4.15), being verbally abused (aOR = 2.27, 95%CI: 1.26-4.07), and being 30+ years of age (aOR = 1.95, 95%CI: 1.05-3.61). Meanwhile, factors that showed negative association with major depression were: providing sexual services at client’s place (aOR=0.46, 95%CI: 0.24-0.91), using modern family planning method (aOR=0.47, 95%CI: 0.25-0.87), and daily intake of alcohol (aOR=0.50, 95%CI: 0.28-0.88).Conclusion: The findings underscore the high prevalence of major depression among female sex workers driven by psychological stress, living with HIV/AIDs, being verbally abused by clients and being 30+years of age. The high prevalence of major depression has important public health ramifications at individual and societal levels and requires urgent attention of all stakeholders.

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High prevalence of HIV and syphilis and associated factors among low-fee female sex workers in mainland China: a cross-sectional study

BMC Infectious Diseases ◽

10.1186/1471-2334-14-225 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 21

Author(s):

Chu Zhou ◽

◽

Keming Rou ◽

Willa M Dong ◽

Yu Wang ◽

...

Keyword(s):

Sex Workers ◽

Associated Factors ◽

Female Sex Workers ◽

Mainland China ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex ◽

High Prevalence

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Relationship between mobility, violence and major depression among female sex workers: a cross-sectional study in southern India

BMJ Open ◽

10.1136/bmjopen-2016-011439 ◽

2016 ◽

Vol 6 (9) ◽

pp. e011439 ◽

Cited By ~ 9

Author(s):

Sangram Kishor Patel ◽

Deepika Ganju ◽

Parimi Prabhakar ◽

Rajatashuvra Adhikary

Keyword(s):

Major Depression ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Southern India ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex

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Association between treatment for gonorrhoea and chlamydia and lower condom use in a cross-sectional study of female sex workers in southern India

BMJ Open ◽

10.1136/bmjopen-2015-009774 ◽

2016 ◽

Vol 6 (5) ◽

pp. e009774

Author(s):

Marianne Legendre-Dugal ◽

Janet Bradley ◽

Subramanian Potty Rajaram ◽

Catherine M Lowndes ◽

Banadakoppa M Ramesh ◽

...

Keyword(s):

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Southern India ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex

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The Risk Factors Analysis Occurrence of Chlamydia Infection to Direct Female Seks Workers (DFSW) in Indonesia

E3S Web of Conferences ◽

10.1051/e3sconf/20186801024 ◽

2018 ◽

Vol 68 ◽

pp. 01024

Author(s):

Masayu Gemala Rabiah ◽

Rini Mutahar ◽

Rico Januar Sitorus

Keyword(s):

Risk Factors ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Chlamydia Infection ◽

Female Sex Worker ◽

Cross Sectional ◽

Sex Worker ◽

Female Sex ◽

The Government

Chlamydia infection is one of the most common sexually transmitted infections worldwide. Based on data of IBBS 2015 in Indonesia, the highest prevalence of chlamydia occurred in direct female sex worker group (32.21%). This study a STIs to determine the risk factors for chlamydia infection in direct sex workers. This research uses Cross-Sectional study design. The population of this study were all direct female sex workers as many as 3,789 people with samples in accordance with inclusion and exclusion criteria as many as 3.114 people. The prevalence of direct female sex workers with chlamydia infection was 1.018 (32.4%). The result of the analysis showed that there was a relationship between age (PR: 0.541 95% CI: 0.456-0.643) and length of work as FDSW (PR: 1,.60, 95% CI: 1.087-1.512) chlamydia infection in female sex workers in Indonesia. most dominant variable has an effect on the incidence of chlamydia infection that is long working as FDSW after controlled by age (PR 1.282 95% CI: 1.087-1,.12). It is expected for the government to improve the implementation of prevention program of chlamydia not only among female sex worker but also proactive to customer.

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HIV prevalence among female sex workers in Guigang City, Guangxi, China: an 8-year consecutive cross-sectional study

BMC Public Health ◽

10.1186/s12889-018-5380-2 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Jingzhen Lai ◽

Chunwei Qin ◽

Eric J. Nehl ◽

Junjun Jiang ◽

Yunxuan Huang ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Hiv Prevalence ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex

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Prevalence and risk of HIV infection among female sex workers in Burkina Faso

International Journal of STD & AIDS ◽

10.1258/0956462981921909 ◽

1998 ◽

Vol 9 (3) ◽

pp. 146-150 ◽

Cited By ~ 33

Author(s):

Salif Lankoande Nicolas ◽

Meda Lassana Sangare ◽

Issaka P Compaore ◽

Joseph Catraye ◽

Paul T Sanou ◽

...

Keyword(s):

Hiv Infection ◽

Burkina Faso ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Transmission ◽

Cross Sectional Study ◽

World Health ◽

Cross Sectional ◽

Female Sex ◽

Bobo Dioulasso

Summary: Little information is available regarding human immunodeficiency virus (HIV) infection among female sex workers (FSW) in Burkina Faso, West Africa. A cross-sectional study was conducted in Ouagadougou and Bobo-Dioulasso, the 2 largest cities of the country, to determine the prevalence of HIV infection and other sexually transmitted diseases (STDs) among FSWs, and to investigate the factors which were associated with HIV infection in this population. From October to November 1994, 426 FSWs were recruited. The method of anonymous and unlinked HIV screening recommended by the World Health Organization (WHO) was used. The overall HIV seroprevalence was 58.2% (95% confidence interval: 53.4-62.9) and 52.6% of FSWs had at least one STD agent. The most common STDs were trichomoniasis (23%), syphilis (15%) and gonorrhoea (13%). In a logistic regression analysis, risk factors for HIV infection were high gravidity ( 2 pregnancies), low perception of personal risk of HIV infection, syphilis and the presence of genital warts. These results suggest that FSWs in Burkina Faso need better information about HIV transmission and prevention and then need better access to STD detection and management services.

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