Family planning use and correlates among female sex workers in a community empowerment HIV prevention intervention in Iringa, Tanzania: a case for tailored programming.
Family planning use and correlates among female sex workers in a community empowerment HIV prevention intervention in Iringa, Tanzania: a case for tailored programming.
复制标题
DOI：
10.1186/s12889-021-11426-z
复制
发表时间：
2021-07-12
影响因子：
4.5
通讯作者：
Kerrigan D
中科院分区：
文献类型：
--
作者：
Beckham SW;Stockton M;Galai N;Davis W;Mwambo J;Likindikoki S;Kerrigan D
撒哈拉以南非洲的女性性工作者面临着计划生育方面的高需求，意外怀孕的风险更高。增强社区能力的艾滋病毒预防方法有可能提高计划生育的接受率，并提供一个将艾滋病毒、生殖健康和避孕结合起来的机会。本文介绍了计划生育的使用和怀孕的女性性工作者在伊林加，坦桑尼亚和评估是否参与社区授权艾滋病预防计划与避孕药具的使用。本研究包括两个社区随机对照试验的二次分析，随后进行了18个月的纵向队列研究。我们实施了一项为期一年的社区赋权干预措施，包括：1）社区主导的救助中心; 2）基于场所的同伴教育、安全套分发和艾滋病毒检测; 3）同伴服务导航; 4）针对提供者和警察的敏感性培训; 5）促进参与的短信。此外，还在救助中心每月举办研讨会，其中一次研讨会的重点是计划生育。使用改良泊松回归模型估计干预组中程序暴露与计划生育使用之间的关联（试验注册NCT 02281578，2014年11月2日）。在339名有计划生育随访数据的参与者中，60%的人报告目前使用计划生育; 6%的人报告现代避孕和避孕套的双重使用; 90%以上的人有活的孩子; 85%的人在最近一次怀孕时寻求产前护理。在185名干预组参与者中，曾参加志卡马纳救助中心的女性性工作者和参加计划生育相关讲习班的女性性工作者的计划生育使用调整相对风险（aRR）分别为26%（aRR 1.26 [95%CI：1.02-1.56]）和36%（aRR 1.36 [95%CI：1.13-1.64）。这一人群显然需要计划生育。一般程序曝光和曝光的计划生育讲习班与较高的计划生育使用，这表明，社区赋权模式有可能增加这一弱势群体的计划生育吸收。
Female sex workers in sub-Saharan Africa face high unmet need for family planning and higher risk for unintended pregnancy. Community empowerment HIV prevention approaches have the potential to increase family planning uptake and present an opportunity to integrate HIV, reproductive health, and contraception. This article describes family planning use and pregnancy among female sex workers in Iringa, Tanzania and evaluates whether engagement in a community empowerment HIV prevention program is associated with contraceptive use. This study consists of secondary analysis from a two-community randomized controlled trial following a longitudinal cohort over 18 months. We implemented a year-long community empowerment intervention consisting of 1) a community-led drop-in-center; 2) venue-based peer education, condom distribution, and HIV testing; 3) peer service navigation; 4) sensitivity trainings for providers and police; and 5) text messages to promote engagement. Additionally, monthly seminars were held at the drop-in-center, one of which focused on family planning. Modified Poisson regression models were used to estimate the association between program exposure and family planning use in the intervention arm. (Trials Registration NCT02281578, Nov 2, 2014.) Among the 339 participants with follow-up data on family planning, 60% reported current family planning use; 6% reported dual use of modern contraception and condoms; over 90% had living children; and 85% sought antenatal care at their most recent pregnancy. Among the 185 participants in the intervention arm, the adjusted relative risk (aRR) of family planning use among female sex workers who reported ever attending the Shikamana drop-in-center and among female sex workers who reported attending a family planning-related workshop was respectively 26% (aRR 1.26 [95% Confidence Interval (CI): 1.02–1.56]) and 36% (aRR 1.36 [95%CI: 1.13–1.64) higher than among those who had not attended. There is a clear need for family planning among this population. General program exposure and exposure to a family planning workshop were associated with higher family planning use, which suggests that community empowerment models have potential to increase family planning uptake for this vulnerable group.
登录
查看更多内容
影响因子：
1
作者：
Duff, Putu;Muzaaya, Godfrey;Shannon, Kate
通讯作者：
Shannon, Kate
DOI：
10.1097/qai.0000000000002123
发表时间：
2019-10-01
影响因子：
3.6
作者：
Kerrigan, Deanna;Mbwambo, Jessie;Galai, Noya
通讯作者：
Galai, Noya
影响因子：
2.6
作者：
Peneza AK;Maluka SO
通讯作者：
Maluka SO
影响因子：
2.1
作者：
Beckham, Sarah W.;Shembilu, Catherine R.;Kerrigan, Deanna L.
通讯作者：
Kerrigan, Deanna L.
影响因子：
2.2
作者：
Nyblade, Laura;Stockton, Melissa;Wamoyi, Joyce
通讯作者：
Wamoyi, Joyce