Emerging trends in contraceptive use, transitions and preferences among female sex workers screened for an HIV prevention clinical trial in Kisumu, Kenya: a cross-sectional study

Background: Globally about 210 million women conceive annually and 38% of these pregnancies are unintended. Female sex workers (FSWs) are at increased risk of both unintended pregnancy and acquiring HIV, which could lead to adverse sexual and reproductive health (SRH) outcomes. We sought to assess contraceptive use or non-use, preferences and determinants among a cohort of FSWs screened for an HIV prevention clinical trial in Kisumu, Kenya. Methods: A cross sectional study of healthy FSWs referred for possible recruitment into the Antibody Mediated HIV Prevention (AMP) Study was conducted between December 2016 and September 2018. Potentially eligible participants were screened for HIV and data on social-demographic, contraceptive use and other SRH characteristics were collected. Those not on a method recorded their contraceptive preferences. Results: Data on 210 FSWs with a median age of 24.5 years (interquartile range, IQR 22-26) are presented. Of these, 187 (89.1%) had two children or fewer; only 56 (26.7%) had completed secondary or higher education. At the time of the interview, 18 (8.6%) were HIV-infected and 181 (86.2%) were using a modern contraceptive. Implants (48.6%) and depot injections (37.6%) were the most commonly used methods. Most (41.4%) of those not on family planning preferred oral pills. Respondents who had two or more children were three times more likely than their primiparous and nulliparous counterparts to report use of a contraceptive. Use of modern contraception methods did not differ by respondent’s ownership of a medical insurance cover or other occupation. Conclusion: There is high use of modern contraception among FSWs in Kisumu with the majority using subdermal implants. Reproductive health programs should implement targeted SRH interventions for specific populations and risk groups. Effective contraceptive counselling and interventions among FSWs should consider the client’s parity and level of education.

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Willingness to use pre-exposure prophylaxis for HIV prevention among female sex workers: a cross-sectional study in China

HIV/AIDS - Research and Palliative Care ◽

10.2147/hiv.s33445 ◽

2012 ◽

pp. 149 ◽

Cited By ~ 4

Author(s):

Bin Peng ◽

Yang ◽

Dai ◽

Liang ◽

Zou ◽

...

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex ◽

Willingness To Use ◽

Exposure Prophylaxis

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Sexualized Drug Use Among Female Sex Workers from Eight Cities in China: A Cross-Sectional Study

Archives of Sexual Behavior ◽

10.1007/s10508-021-02117-2 ◽

2021 ◽

Author(s):

Jason J. Ong ◽

Mingzhou Xiong ◽

Joseph D. Tucker ◽

Yajie Wang ◽

M. Kumi Smith ◽

...

Keyword(s):

Drug Use ◽

Reproductive Health ◽

Health Outcomes ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex ◽

History Of

AbstractThere is a rich literature on sexualized drug use (i.e., drug use before or during sex) for men who have sex with men but less data from female sex workers (FSW), particularly from low- and middle-income countries. We describe the sexual and reproductive health outcomes in FSW reporting sexualized drug use. In 2019, we conducted a cross-sectional study in eight cities from seven provinces in China. We recruited FSW through community organizations working with sex workers and included those aged 18 years or above, exchanged sex at least once for money or goods in the past three months, and had traded sex for longer than a year. Multivariable logistic regression models were used. In total, 650 women participated: average age was 38.8 years (SD 10.2), 57.1% reported a monthly income over 5000 RMB ($USD 707), and 12.8% completed high school or above. Among participants, 65 (10.0%, 95% confidence interval (CI) 7.8–12.6) reported a history of sexualized drug use. Compared to FSW who never reported a history of sexualized drug use, FSW who reported a history of sexualized drug use had greater odds of working for a manager compared to being self-employed (adjusted odds ratio (AOR) 4.04, 95% CI 2.12–7.69), work in a sauna (AOR 2.43, 95% CI 1.09–5.41), charging a higher price for vaginal sex (AOR 2.15, 95% CI 1.14–4.06), and ever diagnosed with STIs (AOR 4.51, 95% CI 2.61–7.80). One in ten FSW reported sexualized drug use. Although they had similar risk profiles in terms of consistency of condom use and reproductive health outcomes, these women were more likely to report past STIs than those who reported no sexualized drug use. Health workers who work with substance users should devote attention to the sexual practices of their clients to make sure that they have safer sex.

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Characteristics of low-tier female sex workers who engage in commercial sex with old male clients in Zhejiang province, China: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2021-049410 ◽

2021 ◽

Vol 11 (11) ◽

pp. e049410

Author(s):

Tingting Jiang ◽

Xiaohong Pan ◽

Qiaoqin Ma ◽

Jianmin Jiang ◽

Lin Chen ◽

...

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Zhejiang Province ◽

Commercial Sex ◽

Sectional Study ◽

Cross Sectional ◽

Male Clients ◽

Working Out

ObjectivesTo characterise low-tier female sex workers (FSWs) who engage in commercial sex with old male clients (OMCs).DesignCross-sectional study.SettingTwenty-one counties in Zhejiang province, China.ParticipantsA total of 2647 low-tier FSWs who participated in our survey from September to November 2013, and responded to the question regarding whether they engaged in commercial sex with OMCs during the previous month.Main outcome measuresData on sociodemographic characteristics, sexual behaviours, risk perception of HIV/sexually transmitted infection (STI), ever exposure to an HIV prevention service and degree of self-efficacy regarding condom use were collected via a face-to-face questionnaire administered by trained interviewers.ResultsOf the 2647 participants, 1165 (44.0%) had engaged in commercial sex with OMCs in the previous month. Low-tier FSWs working out of roadside shops, those who had engaged in sex work for longer, those with a larger number of clients, those who had engaged in anal or oral sex during the previous month, those currently using contraception measures, those who had STI symptoms and those who had been exposed to HIV prevention services during the previous 6 months were more likely to engage in commercial sex with OMCs. FSWs with a high level of education; those working out of small venues other than streets, hair salons and roadside shops; those who charged more for commercial sex; those who had sex with young clients during the previous month and those who had seen a doctor during the previous 6 months were less likely to engage in commercial sex with OMCs.ConclusionsLow-tier FSWs who engaged in commercial sex with OMCs reported more risky behaviours than those who did not engage in this behaviour. Attention should be paid to these behaviours in future interventions targeting low-tier FSWs.

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