At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, Uganda
Abstract Background Female sex workers are vulnerable to HIV, sexually transmitted diseases, and unintended pregnancies; however, the literature on female sex workers (FSW) focuses primarily on HIV and is limited regarding these other health issues. Methods We conducted a respondent-driven sampling...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-022-04977-5 |
| _version_ | 1818517045778579456 |
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| author | Avi J. Hakim Moses Ogwal Reena H. Doshi Herbert Kiyingi Enos Sande David Serwadda Geofrey Musinguzi Jonathan Standish Wolfgang Hladik |
| author_facet | Avi J. Hakim Moses Ogwal Reena H. Doshi Herbert Kiyingi Enos Sande David Serwadda Geofrey Musinguzi Jonathan Standish Wolfgang Hladik |
| author_sort | Avi J. Hakim |
| collection | DOAJ |
| description | Abstract Background Female sex workers are vulnerable to HIV, sexually transmitted diseases, and unintended pregnancies; however, the literature on female sex workers (FSW) focuses primarily on HIV and is limited regarding these other health issues. Methods We conducted a respondent-driven sampling (RDS) survey during April-December 2012 to characterize the reproductive health of and access to contraceptives FSW in Kampala, Uganda. Eligibility criteria included age ≥ 15 years, residence in greater Kampala, and having sold sex to men in ≤ 6 months. Data were analyzed using RDS-Analyst. Survey logistic regression was used in SAS. Results We enrolled 1,497 FSW with a median age of 27 years. Almost all FSW had been pregnant at least once. An estimated 33.8% of FSW were currently not using any form of family planning (FP) to prevent pregnancy; 52.7% used at least moderately effective FP. Among those using FP methods, injectable contraception was the most common form of FP used (55.4%), followed by condoms (19.7%), oral contraception (18.1%), and implants (3.7%). HIV prevalence was 31.4%, syphilis prevalence was 6.2%, and 89.8% had at least one symptom of a sexually transmitted disease in the last six months. Using at least a moderately effective method of FP was associated with accessing sexually transmitted disease treatment in a stigma-free environment in the last six months (aOR: 1.6, 95% CI: 1.1–2.4), giving birth to 2–3 children (aOR: 2.5, 95% CI: 1.4–4.8) or 4–5 children (aOR: 2.9, 95% CI: 1.4–5.9). It is plausible that those living with HIV are also less likely than those without it to be using a moderately effective method of FP (aOR: 0.7, 95% CI: 0.5–1.0). Conclusions The provision of integrated HIV and sexual and reproductive health services in a non-stigmatizing environment has the potential to facilitate increased health service uptake by FSW and decrease missed opportunities for service provision. |
| first_indexed | 2024-12-11T00:50:54Z |
| format | Article |
| id | doaj.art-1bc0f69ee155473abb6b0895f8afa00e |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-11T00:50:54Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-1bc0f69ee155473abb6b0895f8afa00e2022-12-22T01:26:37ZengBMCBMC Pregnancy and Childbirth1471-23932022-08-012211810.1186/s12884-022-04977-5At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, UgandaAvi J. Hakim0Moses Ogwal1Reena H. Doshi2Herbert Kiyingi3Enos Sande4David Serwadda5Geofrey Musinguzi6Jonathan Standish7Wolfgang Hladik8Division of Global HIV and Tuberculosis, US Centers for Disease Control and PreventionSchool of Public Health, Makerere UniversityDivision of Global HIV and Tuberculosis, US Centers for Disease Control and PreventionDivision of Global HIV and Tuberculosis, US Centers for Disease Control and PreventionDivision of Global HIV and Tuberculosis, US Centers for Disease Control and PreventionSchool of Public Health, Makerere UniversitySchool of Public Health, Makerere UniversityDepartment of Counseling and Psychological Services, Georgia State UniversityDivision of Global HIV and Tuberculosis, US Centers for Disease Control and PreventionAbstract Background Female sex workers are vulnerable to HIV, sexually transmitted diseases, and unintended pregnancies; however, the literature on female sex workers (FSW) focuses primarily on HIV and is limited regarding these other health issues. Methods We conducted a respondent-driven sampling (RDS) survey during April-December 2012 to characterize the reproductive health of and access to contraceptives FSW in Kampala, Uganda. Eligibility criteria included age ≥ 15 years, residence in greater Kampala, and having sold sex to men in ≤ 6 months. Data were analyzed using RDS-Analyst. Survey logistic regression was used in SAS. Results We enrolled 1,497 FSW with a median age of 27 years. Almost all FSW had been pregnant at least once. An estimated 33.8% of FSW were currently not using any form of family planning (FP) to prevent pregnancy; 52.7% used at least moderately effective FP. Among those using FP methods, injectable contraception was the most common form of FP used (55.4%), followed by condoms (19.7%), oral contraception (18.1%), and implants (3.7%). HIV prevalence was 31.4%, syphilis prevalence was 6.2%, and 89.8% had at least one symptom of a sexually transmitted disease in the last six months. Using at least a moderately effective method of FP was associated with accessing sexually transmitted disease treatment in a stigma-free environment in the last six months (aOR: 1.6, 95% CI: 1.1–2.4), giving birth to 2–3 children (aOR: 2.5, 95% CI: 1.4–4.8) or 4–5 children (aOR: 2.9, 95% CI: 1.4–5.9). It is plausible that those living with HIV are also less likely than those without it to be using a moderately effective method of FP (aOR: 0.7, 95% CI: 0.5–1.0). Conclusions The provision of integrated HIV and sexual and reproductive health services in a non-stigmatizing environment has the potential to facilitate increased health service uptake by FSW and decrease missed opportunities for service provision.https://doi.org/10.1186/s12884-022-04977-5Female sex workersReproductive HealthHIVFamily planningUganda |
| spellingShingle | Avi J. Hakim Moses Ogwal Reena H. Doshi Herbert Kiyingi Enos Sande David Serwadda Geofrey Musinguzi Jonathan Standish Wolfgang Hladik At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, Uganda BMC Pregnancy and Childbirth Female sex workers Reproductive Health HIV Family planning Uganda |
| title | At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, Uganda |
| title_full | At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, Uganda |
| title_fullStr | At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, Uganda |
| title_full_unstemmed | At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, Uganda |
| title_short | At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, Uganda |
| title_sort | at the intersection of sexual and reproductive health and hiv services use of moderately effective family planning among female sex workers in kampala uganda |
| topic | Female sex workers Reproductive Health HIV Family planning Uganda |
| url | https://doi.org/10.1186/s12884-022-04977-5 |
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