ObjectivesThe objective of this study was to document sexual and reproductive health (SRH) practices among female sex workers (FSWs) including abortion, pregnancy, use of maternal healthcare services and sexually transmitted infections (STIs) with the aim of developing recommendations for action.MethodsA total of 731 FSWs aged between 15 and 49 years were surveyed using a stratified sampling in Dhaka, Bangladesh. A workshop with 23 participants consisted of policy makers, researchers, program implementers was conducted to formulate recommendations.ResultsAbout 61.3% of 731 FSWs reported SRH-related experiences in the past one year, including abortion (15.5%), ongoing pregnancy (9.0%), childbirth (8.3%) or any symptoms of STIs (41.6%). Among FSWs who had an abortion (n = 113), the most common methods included menstrual regulation through manual vacuum aspiration (47.8%), followed by Dilation and Curettage procedure (31%) and oral medicine from pharmacies (35.4%). About 57.5% of 113 cases reported post abortion complications. Among FSWs with delivery in the past year (n = 61), 27.7% attended the recommended four or more antenatal care visits and more than half did not have any postnatal visit. Adopting sustainable and effective strategies to provide accessible and adequate SRH services for FSWs was prioritized by workshop participants.ConclusionThere was substantial unmet need for SRH care among FSWs in urban areas in Dhaka, Bangladesh. Therefore, it is important to integrate SRH services for FSWs in the formal healthcare system or integration of abortion and maternal healthcare services within existing HIV prevention services.

ObjectivesThis study aimed to identify the barriers female sex workers (FSWs) in Bangladesh face with regard to accessing sexual and reproductive health (SRH) care, and assess the satisfaction with the healthcare received.MethodsData were collected from coverage areas of four community-based drop-in-centers (DICs) in Dhaka where sexually transmitted infection (STI) and human immunovirus (HIV) prevention interventions have been implemented for FSWs. A total of 731 FSWs aged 15–49 years were surveyed. In addition, in-depth interviews (IDIs) were conducted with 14 FSWs and 9 service providers. Respondent satisfaction was measured based on recorded scores on dignity, privacy, autonomy, confidentiality, prompt attention, access to social support networks during care, basic amenities, and choice of institution/care provider.ResultsOf 731 FSWs, 353 (51%) reported facing barriers when seeking sexual and reproductive healthcare. Financial problems (72%), shame about receiving care (52.3%), unwillingness of service providers to provide care (39.9%), unfriendly behavior of the provider (24.4%), and distance to care (16.9%) were mentioned as barriers. Only one-third of the respondents reported an overall satisfaction score of more than fifty percent (a score of between 9 and16) with formal healthcare. Inadequacy or lack of SRH services and referral problems (e.g., financial charge at referral centers, unsustainable referral provision, or unknown location of referral) were reported by the qualitative FSWs as the major barriers to accessing and utilizing SRH care.ConclusionsThese findings are useful for program implementers and policy makers to take the necessary steps to reduce or remove the barriers in the health system that are preventing FSWs from accessing SRH care, and ultimately meet the unmet healthcare needs of FSWs.

Despite receiving HIV/STI prevention services, bacterial STIs remain prevalent among FSWs suggesting the need for more effective management of STIs. The guidelines for management of STIs need revision in view of the emerging resistance.

Objective: Female sex workers (FSWs) under 20 years of age range from 1,000 to 575,000 in different cities and countries across the globe. There is only a handful of information on the reproductive health (RH) issues of these younger FSWs in the perspective of service utilization and healthcare system. We reviewed existing literature with a view to describe the reproductive health problems, service utilization, and service availability as well as information sources among the FSWs ages <20 years. Materials and methods: A web-based search using Google, Google Scholar, MEDLINE/ PubMed/ PubMed Central, HINARI and JSTOR was performed in English Language. The prevalence of a health issue and percentage of service utilization had been shown using ranges of minimum and maximum value which were calculated by different studies. Results: Findings identified the following RH problems: unintended pregnancies (52% - 95%), induced abortion (51% - 53%), repeated or multiple abortions (13% - 43%), childbirth experiences, sexually transmitted infections (74%-84%), HIV (1% - 60.6%), violence (beaten, robbed, not paid, forced or coerced sex, rape) and mental disorders (depression, suicidal thoughts). The consistent use of condom (26%-55%) was not satisfactory. Overall 64% of under 20 years FSWs reported little or no access to healthcare in the previous year and access to RH information sources was also poor. Conclusion: This review has potentially meant to bring forward the RH issues of younger FSWs to the policy makers and programme planners to implement targeted reproductive health interventions for the FSWs ages <20 years. Bangladesh Journal of Medical Science Vol.19(1) 2020 p.17-31