دورية أكاديمية
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Unmet Need for Family Planning and Experience of Unintended Pregnancy Among Female Sex Workers in Urban Cameroon: Results From a National Cross-Sectional Study.

التفاصيل البيبلوغرافية
العنوان: Unmet Need for Family Planning and Experience of Unintended Pregnancy Among Female Sex Workers in Urban Cameroon: Results From a National Cross-Sectional Study.
المؤلفون: Bowring AL; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. abowrin1@jhu.edu.; Burnet Institute, Melbourne, Australia., Schwartz S; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Lyons C; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Rao A; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Olawore O; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Njindam IM; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.; Metabiota, Yaounde, Cameroon., Nzau J; CARE SRHR Global Team, Atlanta, GA, USA., Fouda G; CARE Cameroon, Yaounde, Cameroon., Fako GH; Metabiota, Yaounde, Cameroon., Turpin G; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Levitt D; CARE USA, New York, NY, USA., Georges S; CARE Cameroon, Yaounde, Cameroon., Tamoufe U; Metabiota, Yaounde, Cameroon.; Johns Hopkins Cameroon Program, Yaounde, Cameroon., Billong SC; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaounde, Cameroon., Njoya O; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaounde, Cameroon., Zoung-Kanyi AC; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaounde, Cameroon.; Division of Operations Research, Ministry of Health, Yaounde, Cameroon., Baral S; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
المصدر: Global health, science and practice [Glob Health Sci Pract] 2020 Mar 31; Vol. 8 (1), pp. 82-99. Date of Electronic Publication: 2020 Mar 31 (Print Publication: 2020).
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
اللغة: English
بيانات الدورية: Publisher: U.S. Agency for International Development and Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs Country of Publication: United States NLM ID: 101624414 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 2169-575X (Electronic) Linking ISSN: 2169575X NLM ISO Abbreviation: Glob Health Sci Pract Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Baltimore, MD : U.S. Agency for International Development and Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, 2013-
مواضيع طبية MeSH: Needs Assessment* , Pregnancy, Unplanned*, Abortion, Induced/*statistics & numerical data , Contraceptive Agents, Female/*therapeutic use , Intrauterine Devices/*statistics & numerical data , Long-Acting Reversible Contraception/*statistics & numerical data , Sex Workers/*statistics & numerical data , Sterilization, Reproductive/*statistics & numerical data, Abortion, Spontaneous/epidemiology ; Adolescent ; Adult ; Cameroon/epidemiology ; Contraception Behavior ; Contraception, Postcoital/statistics & numerical data ; Contraceptives, Oral/therapeutic use ; Cross-Sectional Studies ; Drug Implants ; Family Planning Services ; Female ; Humans ; Live Birth/epidemiology ; Pregnancy ; Stillbirth/epidemiology ; Surveys and Questionnaires ; Urban Population/statistics & numerical data ; Young Adult
مستخلص: Background: Female sex workers (FSWs) in Cameroon commonly have unmet need for contraception posing a high risk of unintended pregnancy. Unintended pregnancy leads to a range of outcomes, and due to legal restrictions, FSWs often seek unsafe abortions. Aside from the high burden of HIV, little is known about the broader sexual and reproductive health of FSWs in Cameroon.
Methods: From December 2015 to October 2016, we recruited FSWs aged ≥18 years through respondent-driven sampling across 5 Cameroonian cities. Cross-sectional data were collected through a behavioral questionnaire. Modified-robust Poisson regression was used to approximate adjusted prevalence ratios (aPR) for TOP and current use of effective nonbarrier contraception.
Results: Among 2,255 FSWs (median age 28 years), 57.6% reported history of unintended pregnancy and 40.0% reported prior TOP. In multivariable analysis, TOP history was associated with current nonbarrier contraceptive use (aPR=1.23, 95% confidence interval [CI]=1.07, 1.42); ever using emergency contraception (aPR=1.34, 95% CI=1.17, 1.55); >60 clients in the past month (aPR=1.29, 95% CI= 1.07, 1.54) compared to ≤30; inconsistent condom use with clients (aPR=1.17, 95% CI=1.00, 1.37); ever experiencing physical violence (aPR=1.24, 95% CI=1.09, 1.42); and older age. Most (76.5%) women used male condoms for contraception, but only 33.2% reported consistent condom use with all partners. Overall, 26.4% of women reported currently using a nonbarrier contraceptive method, and 6.2% reported using a long-acting method. Previous TOP (aPR=1.41, 95%CI=1.16, 1.72) and ever using emergency contraception (aPR=2.70, 95% CI=2.23, 3.26) were associated with higher nonbarrier contraceptive use. Recent receipt of HIV information (aPR=0.72, 95% CI=0.59, 0.89) and membership in an FSW community-based organization (aPR=0.73, 95% CI=0.57, 0.92) were associated with lower use nonbarrier contraceptive use.
Conclusions: Experience of unintended pregnancies and TOP is common among FSWs in Cameroon. Given the low use of nonbarrier contraceptive methods and inconsistent condom use, FSWs are at risk of repeat unintended pregnancies. Improved integration of client-centered, voluntary family planning within community-led HIV services may better support the sexual and reproductive health and human rights of FSWs consistent with the United Nations Declaration of Human Rights.
(© Bowring et al.)
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معلومات مُعتمدة: T32 AI102623 United States AI NIAID NIH HHS; United States PEPFAR PEPFAR; R01 NR016650 United States NR NINR NIH HHS; P30 AI094189 United States AI NIAID NIH HHS
المشرفين على المادة: 0 (Contraceptive Agents, Female)
0 (Contraceptives, Oral)
0 (Drug Implants)
تواريخ الأحداث: Date Created: 20200403 Date Completed: 20210208 Latest Revision: 20220425
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7108938
DOI: 10.9745/GHSP-D-19-00330
PMID: 32234842
قاعدة البيانات: MEDLINE
الوصف
تدمد:2169-575X
DOI:10.9745/GHSP-D-19-00330