The prevalence and correlates of unintended pregnancy among female sex workers in South China: a cross-sectional study

Abstract

Background: Female sex workers (FSW) are particularly vulnerable to unintended pregnancy. Research examining the experience of unintended pregnancy due to commercial sex among Chinese FSW, however, is limited. This study aimed to examine the prevalence and correlates of unintended pregnancy due to commercial sex among FSW in China. Methods: In 2021, a cross-sectional study was conducted in five cities from Guangdong provinces in South China. Data were collected on social-demographic characteristics, sexual behaviors, experience of unintended pregnancy due to commercial sex and its pregnancy outcome, as well as experience of abortion in lifetime. Multivariable logistic regression analysis was employed to identify factors associated with unintended pregnancy. Results: Among 1257 female sex workers, 19.3% (242/1257) of women reported having at least one unintended pregnancy due to commercial sex, 96.7% (234/242) of participants opted for induced abortion as a means for pregnancy termination. Among those women who experienced unintended pregnancy, 40.5% of individuals (98/242) reported having undergone multiple induced abortion in lifetime. Multivariable logistic regression indicated that women working in high tier (adjusted Odds Ratio (aOR): 0.21, 95%CI: 0.14-0.30), working in current location over one year (aOR: 2.82, 95%CI: 1.71-4.64), using condoms with clients inconsistently in the past month (aOR: 0.16, 95%CI:0.10-0.23), and having more clients in the past week (aOR: 4.53, 95%CI:2.74-7.51) were more likely to experience unintended pregnancy. Conclusions: Unintended pregnancy are prevalent among FSW in South China. Interventions aimed at reducing the prevalence of unintended pregnancy and enhancing post-abortion care could be necessary among Chinese FSW.