Contraceptive utilization among new exotic dancers: a cross-sectional study

Abstract

BackgroundFemale exotic dancers are a population at high risk of unintended pregnancy. The objective of this study is to describe the reproductive health needs and contraceptive utilization of exotic dancers.MethodsNew exotic dancers (< 6 months dancing) from 26 clubs in Baltimore City/County completed a one-time survey.ResultsOf 117 participants, 96 (82%) had current contraceptive need. The mean age was 24 years, and 55% were black. Sex work (45%), alcohol use disorder (73%), illicit (44%; e.g., heroin, crack, cocaine), and injection drug use (8%) were common. The majority (66%) reported contraception use in the prior 6 months. Condoms were reported by 46% whereas 45% reported non-barrier methods, most commonly hormonal injection. Consistent condom use was rare (3%), and only 11% used a long-acting reversible method.ConclusionsDespite their unique reproductive health vulnerabilities, female exotic dancers have unmet contraceptive needs. Targeted harm reduction strategies are needed to fill this gap.

Systematic Review of Contraceptive Use Among Sex Workers in North America

“…Sample sizes ranged from 26 to 1,277 participants in quantitative studies and 23 to 31 participants in qualitative studies. In two studies, researchers addressed stigma and contraceptive method use (Rocha-Jimenez et al, 2018;Terplan et al, 2018). Researchers in four articles addressed the roles of different types of sexual partners (clients and nonpaying romantic partners) and contraceptive use (Decker et al, 2012;Drescher-Burke, 2014;Rocha-Jimenez et al, 2018;Terplan et al, 2018).…”

“…In two studies, researchers addressed stigma and contraceptive method use (Rocha-Jimenez et al, 2018;Terplan et al, 2018). Researchers in four articles addressed the roles of different types of sexual partners (clients and nonpaying romantic partners) and contraceptive use (Decker et al, 2012;Drescher-Burke, 2014;Rocha-Jimenez et al, 2018;Terplan et al, 2018). All researchers addressed a component of health care access such as insurance, co-location of care services at the workplace, and/or use of reproductive health care clinics.…”

“…Two articles addressed pregnancy intention among the participants (Cipres et al, 2017;Duff, Shoveller, Dobrer, et al, 2015). The relationship between substance use by sex workers and contraception was examined in three of the seven included articles (Drescher-Burke, 2014;Duff, Shoveller, Dobrer, et al, 2015;Terplan et al, 2018). Researchers in four studies examined interpersonal violence in the form of IPV (physical or sexual violence) and/or in relation to contraceptive use (a partner's refusal or removal of condoms; Decker et al, 2012;Drescher-Burke, 2014;Duff, Shoveller, Dobrer, et al, 2015;Rocha-Jimenez et al, 2018).…”

“…D espite advances in the efficacy of contraceptives, sex workers experience a disproportionate number of unintended pregnancies (UIPs) compared with women who do not sell sex (Lilleston et al, 2015). Sex workers at risk for UIP include women assigned female sex at birth who exchange sex for food, drugs, money, or goods and subsets of sex workers including exotic dancers (Terplan et al, 2018). The termination of a UIP occurs at least once for 50% to 65% of sex workers and signals unmet reproductive health needs (Schwartz & Baral, 2015;Zhang et al, 2014).…”

“…Exotic dancers (a subset of sex workers) are vulnerable to factors that limit reproductive agency around contraceptive decision making. Nearly half of exotic dancers reported that they engaged in trading sex for money or drugs (Terplan et al, 2018). In qualitative interviews, exotic dancers described sex trade as commonplace and expected as a means to earn more money.…”