Determinants and consequences of heavy episodic drinking among female sex workers in Ethiopia: A respondent-driven sampling study

Abstract

Background Female sex workers (FSW), due to their working conditions, have an increased likelihood of heavy episodic drinking (HED), which is associated with risky sexual behavior. Nevertheless the specific contribution of HED to risky sexual behavior among FSWs in Ethiopia is not well documented for prevention activities. Objective The purpose of this study was to explore the determinants and consequences of HED among FSWs in Ethiopia. Methods A cross-sectional study using respondent-driven sampling was conducted among 4886 FSWs in 11 major towns in Ethiopia in 2014. A structured interview was performed, and data were examined using descriptive statistics and multiple logistic regression analyses. Results Most (66%) FSWs consumed alcohol, and the prevalence of HED was 29.1%. Compared to street-based FSWs, those who worked in bars/hotels and local drinking houses had 2.19 and 1.29 times higher odds of HED, respectively. FSWs who started selling sex when younger than 18 years (compared to those who started when older than 25 years) and those who were forced into selling sex had 1.48 and 2.91 times higher odds of HED, respectively. FSWs with more income from selling sex and FSWs who chewed khat reported increased odds of HED. Moreover, FSWs with experience of HED reported 1.27 and 1.44 times higher odds of physical beating and condom breakage/slippage, respectively. Furthermore, the population attributable risk fraction of HED among FSWs showed that 6.2% of physical beating and 8.9% of condom breakage/slippage could be attributed to HED. Conclusion In general, several factors increase the experience of HED, and HED in turn increases the likelihood of violence and condom breakage. These factors could inform programs and intervention activities among FSWs populations.

Barriers and facilitators for access and utilization of reproductive and sexual health services among Female Sex Workers in urban and rural Maharashtra, India

“…Reliance on condom-only as a contraceptive method by the FSWs in this study has also been reported by FSWs from other parts of the country (16). However, the condom failures were the predominant events in FSWs' lives in this study and other studies as well (15,24,43). The consequent unintended pregnancies were frequent among the FSWs in this study, as reported by other researchers (6,20,(44)(45)(46).…”

Prevalence and correlates of anxiety and depression among female sex workers in Dire Dawa city Administration, Eastern Ethiopia

“…All of the items were added together to get a total score that ranges between 0 and 27. The composite scores were then categorized in to levels of depression as: no depression (0-4), mild depression (5-9), moderate depression (10)(11)(12)(13)(14), moderately severe depression (15)(16)(17)(18)(19) and severe depression (20-27)…”

Condom failure and pre-exposure prophylaxis use experience among female sex workers in Ethiopia: a qualitative study

“…Condom failure is when breaking, leaking, or slipping-off occurs during penetrative sexual activity, and such failure is a frequent experience among FSWs [ 6 – 8 ]. In a study among 4,886 FSW in Ethiopia, 25.5% reported condom breakage/slippage at least once in the past month preceding the survey [ 9 ]. In the aforementioned study, heavy episodic drinking among FSWs was found to be one of the factors that increased condom breakage/slippage [ 9 ].…”

“…In a study among 4,886 FSW in Ethiopia, 25.5% reported condom breakage/slippage at least once in the past month preceding the survey [ 9 ]. In the aforementioned study, heavy episodic drinking among FSWs was found to be one of the factors that increased condom breakage/slippage [ 9 ]. Further, a study among 291 FSWs conducted in India also found that lack of experience and incorrect handling of the male condom contributed to condom breakage [ 10 ].…”