J Fam Plann Reprod Health Care doi:10.1136/jfprhc-2012-100527
  • Article

Use of emergency contraceptive pills among female sex workers in Swaziland

  1. Stefan Baral5
  1. 1Associate, Population Council, Washington, DC, USA
  2. 2HIV/STI Manager, Swaziland National AIDS Programme, Ministry of Health, Mbabane, Swaziland
  3. 3Associate, The Rock of Hope-Lidvwala Lelitsemba, Manzini, Swaziland
  4. 4Assistant Professor, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  5. 5Assistant Scientist, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  1. Correspondence to Dr Eileen A Yam, 4301 Connecticut Ave NW Ste 280, Population Council, Washington, DC 20008, USA; eyam{at}
  • Received 27 October 2012
  • Revised 18 February 2013
  • Accepted 26 April 2013
  • Published Online First 21 June 2013


Objectives Female sex workers (FSW) often have unprotected sex. Emergency contraceptive pills (ECP) are an important back-up method to prevent unwanted pregnancy among FSW. We examine ECP use among FSW in Swaziland.

Methods Using data from a 2011 respondent-driven sampling survey of 325 Swazi FSW, we explored the association between individual characteristics and ever having used ECP.

Results In weighted analyses, 27.5% of FSW had ever used ECP. Most (77.8%) had ever been pregnant, among whom 48.7% had had an unwanted pregnancy and 11.7% had had an abortion. Nearly half (47.5%) had experienced condom failure in the past month. Significant independent correlates of ECP use were younger age, higher education, higher income, having two or more children, and never having been married.

Conclusions FSW who are older or of lower socioeconomic status may not have adequate access to ECP. By better addressing these women's family planning needs, the dual goals of preventing unwanted pregnancy and preventing vertical transmission of HIV can be achieved.

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