High Lifetime Pregnancy and Low Contraceptive Usage Among Sex Workers Who Use Drugs- An Unmet Reproductive Health Need
High Lifetime Pregnancy and Low Contraceptive Usage Among Sex Workers Who Use Drugs- An Unmet Reproductive Health Need
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DOI：
10.1186/1471-2393-11-61
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发表时间：
2011-08-18
影响因子：
3.1
通讯作者：
Shannon, Kate
中科院分区：
文献类型：
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作者：
Duff, Putu;Shoveller, Jean;Shannon, Kate
背景资料：本研究的目的是描述一个队列的街头女性性工作者（FSWs）在温哥华. Methods：研究样本是从一个以社区为基础的前瞻性队列研究（2006 - 2008年）的211名妇女在街头性工作谁使用药物，其中176人至少有一个以前怀孕的水平。描述性统计用于估计终生妊娠率、妊娠结局（流产、人工流产、收养、儿童忧虑、儿童监护）和避孕措施使用情况。在二次分析中，避孕药具的使用，个人和人际关系的危险因素和大量的终身妊娠（定义为大于样本平均值4）之间的关联进行了examined.Results：在我们的样本中，84%的报告以前怀孕，平均4终身妊娠（中位数= 3; IQR：2 - 5）。报告5次以上妊娠的女性的中位年龄为38岁[四分位距（IQR）：25.0 - 39.0]，而报告4次或更少既往妊娠的女性的中位年龄为34岁[IQR：25.0 - 39.0]。45%是高加索人，47%是原住民血统。我们观察到，在报告既往妊娠的FSW中，既往流产（中位数= 1; IQR：1 - 3）、恐惧（中位数= 2; IQR：1 - 4）和收养（中位数= 1; IQR：1 - 2）的发生率较高。激素和插入式避孕药的使用有限。在双变量分析中，输卵管结扎（OR = 2.49;[95%CI = 1.14 - 5.45]）和永久避孕（e.例如，在一个实施例中，输卵管结扎术和子宫切除术）（OR = 2.76;[95%CI = 1.36 - 5.59]）均与5次或5次以上妊娠显著相关。这些调查结果表明，在有效避孕药具利用率低的情况下，意外怀孕率很高，并表明需要改善生殖健康服务，包括计划生育服务的获得和利用，这些都是为温哥华的性服务工作者量身定做的。
Background: The objective of this study was to describe levels of pregnancy and contraceptive usage among a cohort of street-based female sex workers (FSWs) in Vancouver.Methods: The study sample was obtained from a community-based prospective cohort study (2006-2008) of 211 women in street-based sex work who use drugs, 176 of whom had reported at least one prior pregnancy. Descriptive statistics were used to estimate lifetime pregnancy prevalence, pregnancy outcomes (miscarriage, abortion, adoption, child apprehension, child custody), and contraceptive usage. In secondary analyses, associations between contraceptive usage, individual and interpersonal risk factors and high number of lifetime pregnancies (defined as greater than the sample mean of 4) were examined.Results: Among our sample, 84% reported a prior pregnancy, with a mean of 4 lifetime pregnancies (median = 3; IQR: 2-5). The median age of women reporting 5+ pregnancies was 38 years old [interquartile range (IQR): 25.0-39.0] compared to 34 years [IQR: 25.0-39.0] among women reporting 4 or fewer prior pregnancies. 45% were Caucasian and 47% were of Aboriginal ancestry. We observed high rates of previous abortion (median = 1; IQR: 1-3), apprehension (median = 2; IQR: 1-4) and adoption (median = 1; IQR: 1-2) among FSWs who reported prior pregnancy. The use of hormonal and insertive contraceptives was limited. In bivariate analysis, tubal ligation (OR = 2.49; [95% CI = 1.14-5.45]), and permanent contraceptives (e. g., tubal ligation and hysterectomy) (OR = 2.76; [95% CI = 1.36-5.59]) were both significantly associated with having five or more pregnancies.Conclusion: These findings demonstrate high levels of unwanted pregnancy in the context of low utilization of effective contraceptives and suggest a need to improve the accessibility and utilization of reproductive health services, including family planning, which are appropriately targeted and tailored for FSWs in Vancouver.