Factors associated with induced abortion among female entertainment workers: a cross-sectional study in Cambodia

Yi, Siyan; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Tith, Khimuy; Brody, Carinne

doi:10.1136/bmjopen-2015-007947

Cited by 30 publications

(33 citation statements)

References 19 publications

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“…Elsewhere, a study in China conducted among adolescent FSWs also found general sexual and reproductive health knowledge to be low, and while 98% reported not wanting the pregnancy, less than half (43%) reported consistent condom use with another 28% reporting current use of another contraceptive method [27]. A separate study examining contraceptive use among female entertainment sex workers in Cambodia found several factors to be linked to unwanted pregnancy such as the increase in a number of clients, inconsistent condom use, condom breakage and forced unprotected sex [28]. Elsewhere, unwanted pregnancy was more common among older married women who additionally had lower contraceptive knowledge [29].…”

Section: Discussionmentioning

confidence: 99%

“…Other barriers were those related to access to the services which included fear of getting tested for HIV whenever they visited family planning clinics, competition in clinic time and time for clients, among other barriers. To increase family planning uptake among FSW in Cambodia, the government and NGOs provide free and friendly sexual and reproductive health services, despite this, some FSW still reported barriers such as discrimination by providers thereby making them resort to using of private providers [28]. …”

Section: Discussionmentioning

confidence: 99%

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Female sex workers experiences of using contraceptive methods: a qualitative study in Kenya

et al. 2018

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BackgroundFemale Sex Workers (FSWs) are predisposed to a broad range of social, sexual and reproductive health problems such as sexually transmitted infections (STIs)/HIV, unintended pregnancy, violence, sexual exploitation, stigma and discrimination. Female sex workers have unmet need for contraceptives and require comprehensive Sexual and Reproductive Health (SRH) prevention interventions. Existing programs pay little attention to the broad sexual and reproductive health and rights of these women and often focus on HIV and other STIs prevention, care and treatment while neglecting their reproductive health needs, including access to family planning methods. The aim of this study is, therefore, to explore the experiences of female sex workers with using existing contraceptive methods, assess individual and health facility-level barriers and document inter-partner relationship in the use of contraceptives.MethodsWe focus on women aged 15–49, who reported current sex work, defined as ‘providing sexual services in exchange for money or other material compensation as part of an individual’s livelihood.’ResultsFindings reveal that while some FSWs know about modern contraceptives, others have limited knowledge or out rightly refuse to use contraceptives for fear of losing clients. The interaction with different client types act as a barrier but also provide an opportunity for contraceptive use among FSWs. Most FSWs recognize the importance of dual protection for HIV/STI and pregnancy prevention. However, myths and misconceptions, fear of being tested for HIV at the family planning clinic, wait time, and long queues at the clinics all act in combination to hinder uptake of contraceptives.ConclusionsWe recommend a targeted approach to address the contraceptive needs of FSWs to help remove barriers to contraceptive uptake. We also support the introduction of counseling services to provide information on the benefits of non-barrier contraceptive methods and thereby enhance dual use for both pregnancy and STI/HIV prevention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Female sex workers experiences of using contraceptive methods: a qualitative study in Kenya

et al. 2018

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“…Moreover, we recently found that 54% of FEWs reported at least one induced abortion during their lifetime, and 33% while working as a FEW [12]. The rates of consistent condom use with commercial and non-commercial partners in the past three months were 79 and 31%, respectively [13]. Through the five years of the SAHACOM lifespan, the rates of condom use with both commercial and non-commercial partners were not appreciably improved [12].…”

Section: Introductionmentioning

confidence: 99%

Sex with sweethearts: Exploring factors associated with inconsistent condom use among unmarried female entertainment workers in Cambodia

Tuot²,

Chhoun³

et al. 2017

BMC Infect Dis

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BackgroundDespite the success in promoting condom use in commercial relationships, condom use with regular, noncommercial partners remains low among key populations in Cambodia. This study explores factors associated inconsistent condom use with sweethearts among unmarried sexually active female entertainment workers (FEWs).MethodsIn 2014, the probability proportional to size sampling method was used to randomly select 204 FEWs from entertainment venues in Phnom Penh and Siem Reap for face-to-face interviews. Multivariate logistic regression analysis was conducted to examine independent determinants of inconsistent condom use.ResultsOf total, 31.4% of the respondents reported consistent condom use with sweethearts in the past three months. After adjustment, respondents who reported inconsistent condom use with sweethearts remained significantly less likely to report having received any form of sexual and reproductive health education (AOR = 0.49, 95% CI = 0.22–0.99), but more likely to report having been tested for HIV in the past six months (AOR = 2.19, 95% CI = 1.03–4.65). They were significantly more likely to report having used higher amount of alcohol in the past three months (AOR = 1.29, 95% CI = 1.01–1.99) and currently using a contraceptive method other than condoms such as pills (AOR = 4.46, 95% CI = 1.34–10.52) or other methods (AOR = 9.75, 95% CI = 2.07–9.86).ConclusionsThe rate of consistent condom use in romantic relationships among unmarried FEWs in this study is considerably low. The importance of consistent condom use with regular, non-commercial partners should be emphasized in the education sessions and materials, particularly for FEWs who use non-barrier contraceptive methods.

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“…Fourth, to the best of our knowledge, there is no published study that evaluates the factors associated with HIV/STI testing behaviour of heterosexual men patronising entertainment establishments (EEs) who engage in casual or paid sex. EEs are karaoke lounges, bars, pubs, nightclubs and discotheques that provide entertainment activities such as singing, dancing and social drinking [21]. In recent years, sex work has increasingly shifted from brothels to EEs, particularly in Asia [22].…”

Section: Introductionmentioning

confidence: 99%

What are the factors associated with human immunodeficiency virus/sexually transmitted infection screening behaviour among heterosexual men patronising entertainment establishments who engaged in casual or paid sex? – Results from a cross-sectional survey in an Asian urban setting

et al. 2016

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BackgroundLate presentation of human immunodeficiency virus (HIV) is associated with heterosexual transmission, particularly among heterosexual men in Asia. Although data on HIV/sexually transmitted infection (STI) testing behaviour is increasing, information is still lacking among heterosexual men who receive far lesser attention and are generally invisible in HIV/ STI prevention, particularly in the Asian urban setting. The aim of this study was to assess the prevalence of HIV/STI testing among heterosexual men patronising entertainment establishments (EEs) who engaged in casual or paid sex in Singapore, and the factors associated with this behaviour.MethodsThis was a cross-sectional survey involving 604 participants using time location sampling between March and May 2015. For multivariable analysis, we used a mixed effects Poisson regression model with backward stepwise approach to account for clustering by venue and to obtain the adjusted prevalence ratio (aPR) for the association of various factors with HIV/STI testing.ResultsAmong 604 at-risk participants, only 163 (27.0%) had gone for HIV or STI testing in the past 6 months. Of this, 83.4% of them specifically underwent HIV testing. In multivariable analysis, HIV/STI testing increased with being non-Chinese (aPR 1.50; 95% CI: 1.08–2.06), having engaged in anal sex with casual or paid partner in the past 6 months (aPR 1.80; 95% CI: 1.27–2.57), number of partners in the past 6 months (aPR 1.03; 95% CI: 1.01–1.05) and HIV knowledge score (aPR 1.11; 95% CI: 1.05–1.16). Among those who reported non-consistent condom use with casual or paid partner, almost half of them (47.9%) perceived that they were at low risk for HIV/STI. Sigmatisation and discrimination was another common barrier for non-testing.ConclusionsDespite being at risk of HIV/STI, the low prevalence of testing coupled with a high prevalence of risky sexual behaviour among this group of heterosexual men in Singapore calls for a need for HIV/STI prevention interventions in the EE setting. Other than promoting testing and safer sex, the interventions should address the discordance between perceived risk and actual sexual behaviour, in addition to the stigma and discrimination associated with testing for this group.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2088-8) contains supplementary material, which is available to authorized users.

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Factors associated with induced abortion among female entertainment workers: a cross-sectional study in Cambodia

Cited by 30 publications

References 19 publications

Female sex workers experiences of using contraceptive methods: a qualitative study in Kenya

Female sex workers experiences of using contraceptive methods: a qualitative study in Kenya

Sex with sweethearts: Exploring factors associated with inconsistent condom use among unmarried female entertainment workers in Cambodia

What are the factors associated with human immunodeficiency virus/sexually transmitted infection screening behaviour among heterosexual men patronising entertainment establishments who engaged in casual or paid sex? – Results from a cross-sectional survey in an Asian urban setting

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