Article Text

other Versions

PDF
Reproductive health needs of female sex workers and opportunities for enhanced prevention of mother-to-child transmission efforts in sub-Saharan Africa
  1. Sheree R Schwartz1,
  2. Erin Papworth2,
  3. Odette Ky-Zerbo3,
  4. Bhekie Sithole4,
  5. Simplice Anato5,
  6. Ashley Grosso6,
  7. Henri Gautier Ouedraogo7,
  8. Jules Tchalla8,
  9. Cebisile Ntshangase9,
  10. Sosthenes Ketende10,
  11. Stefan Baral11
  1. 1Assistant Scientist, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  2. 2Senior Technical Advisor, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  3. 3Investigator, Programme d'Appui au Monde Associatif et Communautaire (PAMAC), Ouagadougou, Burkina Faso
  4. 4Research Assistant, Rock of Hope, Mbabane, Swaziland
  5. 5Director, Arc-en-Ciel, Lome, Togo
  6. 6Senior Research Coordinator, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  7. 7Investigator, Institut de Recherche en Sciences de la Santé (IRSS/CNRST), Ouagadougou, Burkina Faso
  8. 8Monitoring and Evaluation Coordinator, Espoir de Vie, Lome, Togo
  9. 9Investigator, Swaziland National AIDS Program (SNAP), Ministry of Health, Mbabane, Swaziland
  10. 10Senior Biostatistician, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  11. 11Associate Professor and Director, Key Populations Program, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  1. Correspondence to Dr Sheree R Schwartz, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7138, Baltimore, MD 21205, USA; sschwartz{at}jhu.edu

Abstract

Introduction HIV infection and pregnancy are both common among female sex workers (FSW), indicating the need for prevention of mother-to-child transmission (PMTCT) among FSW.

Methods FSW were enrolled into studies in Swaziland, Burkina Faso and Togo using respondent-driven sampling. Women completed interview-administered socio-behavioural surveys and HIV counselling and testing. This secondary analysis describes contraceptive use and attempted pregnancy among reproductive-aged FSW (16–49 years). Robust Poisson regression with generalised estimating equations to account for clustering within recruitment networks was used to separately estimate associations between current unmet contraceptive need and attempted pregnancy among FSW.

Results Overall 1666 FSW were enrolled, 1372 (82.4%) of whom had ever been pregnant. In Togo and Burkina Faso, 83 FSW reported a prior HIV diagnosis and having a child, of which 12.1% (10/83) reported a child known to be HIV-positive. Twenty-five per cent of FSW had an unmet need for contraception; 9% of FSW employed dual contraception, including highly effective non-barrier methods and consistent condom use. Consistent condom use varied substantially by partner type and was higher with clients than non-paying partners. Nineteen per cent (n=313/1666) of FSW were trying to conceive. HIV-positive, undiagnosed FSW were more likely to be trying to conceive as compared to HIV-negative FSW; among 98 HIV-positive women trying to conceive, 25.5% were on antiretroviral therapy.

Conclusions FSW have varying reproductive goals and contraceptive usage. Efforts to improve coverage of comprehensive family planning – including efforts to increase HIV testing and engagement in treatment among FSW trying to conceive – are necessary for PMTCT.

  • epidemiology
  • family planning service provision
  • needs assessment
  • female sex workers
  • prevention of mother-to-child transmission

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Highlights from this issue
    British Medical Journal Publishing Group