At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, Uganda.
At the intersection of sexual and reproductive health and HIV services: use of moderately effective family planning among female sex workers in Kampala, Uganda.
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DOI：
10.1186/s12884-022-04977-5
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发表时间：
2022-08-17
影响因子：
3.1
通讯作者：
中科院分区：
文献类型：
--
作者：
女性性工作者容易感染艾滋病毒、性传播疾病和意外怀孕;然而，关于女性性工作者（FSW）的文献主要集中在艾滋病毒上，而关于这些其他健康问题的文献有限。 我们在2012年4月至12月期间进行了一项应答者驱动抽样（RDS）调查，以描述乌干达坎帕拉FSW的生殖健康和获得避孕药具的情况。合格标准包括年龄≥ 15岁，居住在大坎帕拉，并在≤ 6个月内向男性出售性服务。使用RDS-Analyst分析数据。SAS采用Logistic回归分析。我们招募了1，497名FSW，中位年龄为27岁。几乎所有的FSW都至少怀孕过一次。据估计，33.8%的FSW目前没有使用任何形式的计划生育（FP）来预防怀孕; 52.7%的FSW使用了至少适度有效的计划生育。在使用FP方法的人中，注射避孕是最常见的FP形式（55.4%），其次是避孕套（19.7%），口服避孕药（18.1%）和植入物（3.7%）。艾滋病毒感染率为31.4%，梅毒感染率为6.2%，89.8%的人在过去六个月内至少有一种性传播疾病的症状。使用至少一种中等有效的FP方法与过去6个月内在无污名环境中获得性传播疾病治疗相关（aOR：1.6，95% CI：1.1-2.4），生育2-3个孩子（aOR：2.5，95% CI：1.4-4.8）或4-5个孩子（aOR：2.9，95% CI：1.4-5.9）。有可能的是，艾滋病毒感染者使用中等有效FP方法的可能性也低于未感染者（aOR：0.7，95%CI：0.5-1.0）。在非污名化环境中提供艾滋病毒与性健康和生殖健康的综合服务，有可能促进家庭福利工作者更多地利用保健服务，减少错失提供服务的机会。
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. 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. 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). 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.
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