Sexual and reproductive health services utilization by female sex workers is contextspecific : results from a cross-sectional survey in India, Kenya, Mozambique and South Africa

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dc.contributor.authorLafort, Yvesen_ZA
dc.contributor.authorGreener, Rossen_ZA
dc.contributor.authorRoy, Anuradhaen_ZA
dc.contributor.authorGreener, Letitiaen_ZA
dc.contributor.authorOmbidi, Wilkisteren_ZA
dc.contributor.authorLessitala, Faustinoen_ZA
dc.contributor.authorSkordis-Worrall, Joleneen_ZA
dc.contributor.authorBeksinska, Magsen_ZA
dc.contributor.authorGichangi, Peteren_ZA
dc.contributor.authorReza-Paul, Sushenaen_ZA
dc.contributor.authorSmit, Jenni A.en_ZA
dc.contributor.authorChersich, Matthewen_ZA
dc.contributor.authorDelva, Wimen_ZA
dc.date.accessioned2018-11-21T07:28:12Z
dc.date.available2018-11-21T07:28:12Z
dc.date.issued2017
dc.descriptionCITATION: Lafort, Y., et al. 2017. Sexual and reproductive health services utilization by female sex workers is contextspecific : results from a cross-sectional survey in India, Kenya, Mozambique and South Africa. Reproductive Health, 14:13, doi:10.1186/s12978-017-0277-6.
dc.descriptionThe original publication is available at https://reproductive-health-journal.biomedcentral.com
dc.description.abstractBackground: Female sex workers (FSWs) are extremely vulnerable to adverse sexual and reproductive health (SRH) outcomes. To mitigate these risks, they require access to services covering not only HIV prevention but also contraception, cervical cancer screening and sexual violence. To develop context-specific intervention packages to improve uptake, we identified gaps in service utilization in four different cities. Methods: A cross-sectional survey was conducted, as part of the baseline assessment of an implementation research project. FWSs were recruited in Durban, South Africa (n = 400), Mombasa, Kenya (n = 400), Mysore, India (n = 458) and Tete, Mozambique (n = 308), using respondent-driven sampling (RDS) and starting with 8-16 ‘seeds’ identified by the peer educators. FSWs responded to a standardised interviewer-administered questionnaire about the use of contraceptive methods and services for cervical cancer screening, sexual violence and unwanted pregnancies. RDS-adjusted proportions and surrounding 95% confidence intervals were estimated by non-parametric bootstrapping, and compared across cities using post-hoc pairwise comparison tests with Dunn–Šidák correction. Results: Current use of any modern contraception ranged from 86.2% in Tete to 98.4% in Mombasa (p = 0.001), while non-barrier contraception (hormonal, IUD or sterilisation) varied from 33.4% in Durban to 85.1% in Mysore (p < 0.001). Ever having used emergency contraception ranged from 2.4% in Mysore to 38.1% in Mombasa (p < 0.001), ever having been screened for cervical cancer from 0.0% in Tete to 29.0% in Durban (p < 0.001), and having gone to a health facility for a termination of an unwanted pregnancy from 15.0% in Durban to 93.7% in Mysore (p < 0.001). Having sought medical care after forced sex varied from 34.4% in Mombasa to 51.9% in Mysore (p = 0.860). Many of the differences between cities remained statistically significant after adjusting for variations in FSWs’ sociodemographic characteristics. Conclusion: The use of SRH commodities and services by FSWs is often low and is highly context-specific. Reasons for variation across cities need to be further explored. The differences are unlikely caused by differences in socio-demographic characteristics and more probably stem from differences in the availability and accessibility of SRH services. Intervention packages to improve use of contraceptives and SRH services should be tailored to the particular gaps in each city.en_ZA
dc.description.urihttps://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-017-0277-6
dc.description.versionPublisher's version
dc.format.extent10 pages
dc.identifier.citationLafort, Y., et al. 2017. Sexual and reproductive health services utilization by female sex workers is contextspecific : results from a cross-sectional survey in India, Kenya, Mozambique and South Africa. Reproductive Health, 14:13, doi:10.1186/s12978-017-0277-6
dc.identifier.issn1742-4755 (online)
dc.identifier.otherdoi:10.1186/s12978-017-0277-6
dc.identifier.urihttp://hdl.handle.net/10019.1/104711
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.rights.holderAuthors retain copyright
dc.subjectFemale sex workersen_ZA
dc.subjectReproductive health servicesen_ZA
dc.subjectSexual healthen_ZA
dc.subjectSex workers -- Health and hygieneen_ZA
dc.titleSexual and reproductive health services utilization by female sex workers is contextspecific : results from a cross-sectional survey in India, Kenya, Mozambique and South Africaen_ZA
dc.typeArticleen_ZA
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