Reproductive health needs of female sex workers and opportunities for enhanced prevention of mother-to-child transmission efforts in sub-Saharan Africa

Schwartz, Sheree; Papworth, Erin; Ky-Zerbo, Odette; Sithole, Bhekie; Anato, Simplice; Grosso, Ashley; Ouédraogo, Henri Gautier; Tchalla, Jules; Cebisile, Ntshangase; Ketende, Sosthenes; Baral, Stefan

doi:10.1136/jfprhc-2014-100968

Cited by 19 publications

(23 citation statements)

References 22 publications

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“…Our findings also show that one-third (33.2%) of FSWs reported using no FP method and took no FP method at their Sauti visit, including condoms. Self-reported consistent condom use (with all partners, paying and non-paying) (16.1%) was also lower than in studies conducted in the region: a Swaziland study reported 23.5% consistent condom use [8], a Democratic Republic of the Congo study reported 40.0% [9], and a Swaziland, Togo, and Burkina Faso study showed 17.0% [7]. We acknowledge that the differences may be a byproduct of the methodologies associated with measurement design in a research setting, compared to a service delivery setting.…”

Section: Discussioncontrasting

confidence: 54%

“…The study also revealed a complex pattern of paternity, with 36% of pregnancies among FSW being attributed to non-paying partners such as husbands or boyfriends, 23% to regular clients and 28% to casual clients [26]. In Togo, Burkina Faso, and Swaziland, 19% of FSWs in the study reported that they were trying to conceive [7]. The complexities of decision-making around FP choices and fertility intentions were beyond the scope of the study.…”

Section: Discussionmentioning

confidence: 91%

“…FP use is important for preventing unintended pregnancies, which are common among FSWs [6]; use of a barrier method also reduces STI/HIV acquisition and transmission. A study of FSWs in three sub-Saharan African countries (Burkina Faso, Swaziland, and Togo) showed significant and consistent unmet need for FP [7]. Although new biomedical breakthroughs such as pre-exposure prophylaxis have the potential to prevent HIV infection, they are not yet widely available.…”

Section: Introductionmentioning

confidence: 99%

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Consistent Condom Use and Dual Protection Among Female Sex Workers: Surveillance Findings from a Large-Scale, Community-Based Combination HIV Prevention Program in Tanzania

Mbita¹,

Mwanamsangu²,

Plotkin³

et al. 2019

AIDS Behav

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In Tanzania, HIV infection remains much higher among female sex workers (FSWs) than among other adult women. In addition to HIV, sexually transmitted infections (STIs) and pregnancy prevention are major concerns for FSWs in Tanzania. This study used a programmatic surveillance approach to examine protection against STIs/HIV and unintended pregnancy (dual method use) among FSWs in an outreach-based HIV prevention, care, and treatment program in Tanzania. 119,728 FSWs made a first visit to services served by the Sauti Project from January 2016 to September 2017. Of these 79,774 were current contraceptive users-of those, 4548 (5.7%) took a contraceptive as well as condoms, the study measure of dual family planning (FP) method use. Ninety-one percent (n = 4139) of FSWs taking dual FP methods were provided with an injectable in addition to condoms. Dual method use was lower in this study than in research studies in the region, highlighting potential differences between findings from research studies and evidence from a routine service provision setting. Self-reported consistent condom use among FSWs was 16.1%. The findings call for further research and programs to address FSW agency to increase dual protection against STIs/HIV and unintended pregnancy.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Consistent Condom Use and Dual Protection Among Female Sex Workers: Surveillance Findings from a Large-Scale, Community-Based Combination HIV Prevention Program in Tanzania

Mbita¹,

Mwanamsangu²,

Plotkin³

et al. 2019

AIDS Behav

View full text Add to dashboard Cite

show abstract

“…In a further analysis of the data from Burkina Faso and Togo, as well as data from Swaziland, FSWs who were living with HIV but had been previously undiagnosed were more likely to be trying to conceive compared to those who were HIV‐negative (Schwartz, Papworth, Ky‐Zerbo, et al. ). These findings further support the need for safer conception services to minimize HIV acquisition or transmission among members of key populations who are trying to conceive.…”

Section: Pregnancy Intentionsmentioning

confidence: 99%

Meeting the Reproductive Health Needs of Female Key Populations Affected by HIV in Low‐ and Middle‐Income Countries: A Review of the Evidence

Ippoliti¹,

Nanda²,

Wilcher³

2017

Studies in Family Planning

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S ex workers, injection drug users, men who have sex with men, and transgender individuals shoulder a disproportionate burden of HIV (Wheeler et al. 2015). UNAIDS (2014a) estimates that 40-50 percent of all new HIV infections among adults worldwide occur among these key populations. HIV among these key populations is driven by a myriad of behavioral and structural factors, including drug use, violence, sex with multiple and concurrent partners, inconsistent condom use, stigma and discrimination, and criminalization. Although these factors also increase the risk of poor reproductive health outcomes (WHO 2014), relatively little attention has been paid to the reproductive health needs of key populations.

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“…7 Characterization of the needs of these women is important, given their unique occupational risks, fertility-related concerns, child-care needs and potential barriers to accessing support services and health care emanating from social stigma and discrimination. 8,9 …”

Section: Introductionmentioning

confidence: 99%

Motherhood and Risk for Human Immunodeficiency Virus/Sexually Transmitted Infections Among Female Sex Workers in the Mexico-US Border Region

Servin¹,

Reed

Brouwer³

et al. 2017

Sexual Trans Dis

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Background Globally, female sex workers (FSWs) have been identified as a high-risk group for HIV and sexually transmitted infections (STIs). However, as women of reproductive age, FSWs also have children. Few studies have investigated if financial responsibilities associated with motherhood increase women’s vulnerability to HIV and STIs among FSWs. Methods From March 2013 to March 2014, 603 FSWs ≥18 years of age were recruited from Tijuana and Ciudad Juarez (Mexico) to participate in a study assessing HIV/STI risk environments. Results Findings from logistic regression models indicate that FSWs who reported motherhood were more likely to report (in the past 30 days): a higher client volume (>30 clients) (adjusted odds ratio [AOR]= 1.91; 95% confidence interval (CI) 1.27–2.87) and always using alcohol right before or during sex with clients in the past 30 days (AOR=1.77; 95%CI 1.19–2.61). In contrast, they were more likely to report consistent condom use for vaginal or anal sex with clients (AOR-1.68; 95% CI 1.10–2.55), less likely to report using drugs right before or during sex with clients (AOR=0.38; 95%CI 0.26–0.56) and less likely to have tested positive for STIs at baseline (AOR=0.63; 95% CI: 0.43–0.91). Conclusions These results provide a glimpse of the complex relationship between motherhood and women who are sex workers. Understanding the convergence of motherhood and sex work and how this can influence a woman’s decision when engaging in sex work and affect her health, is essential to designing effective programs addressing reduce risk for HIV and STIs among FSWs in this region and elsewhere.

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Reproductive health needs of female sex workers and opportunities for enhanced prevention of mother-to-child transmission efforts in sub-Saharan Africa

Abstract: 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.

Cited by 19 publications

References 22 publications

Consistent Condom Use and Dual Protection Among Female Sex Workers: Surveillance Findings from a Large-Scale, Community-Based Combination HIV Prevention Program in Tanzania

Consistent Condom Use and Dual Protection Among Female Sex Workers: Surveillance Findings from a Large-Scale, Community-Based Combination HIV Prevention Program in Tanzania

Meeting the Reproductive Health Needs of Female Key Populations Affected by HIV in Low‐ and Middle‐Income Countries: A Review of the Evidence

Motherhood and Risk for Human Immunodeficiency Virus/Sexually Transmitted Infections Among Female Sex Workers in the Mexico-US Border Region

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