TY - JOUR
T1 - Assessment of the lifetime prevalence and incidence of induced abortion and correlates among female sex workers in Mombasa, Kenya
T2 - a secondary cohort analysis
AU - Simmelink, Anne Marieke
AU - Gichuki, Caroline M.
AU - Ampt, Frances H.
AU - Manguro, Griffins
AU - Lim, Megan S.C.
AU - Agius, Paul
AU - Hellard, Margaret
AU - Jaoko, Walter
AU - Stoové, Mark A.
AU - L'Engle, Kelly
AU - Temmerman, Marleen
AU - Gichangi, Peter
AU - Luchters, Stanley
N1 - Funding Information:
The authors would like to acknowledge the hard work of the field research team, specifically Christine Maghanga, Millicent Okello, Betty Kitili, Judith Wamaua, Elizabeth Bilasi, Marion Mwangi, Promillah Muindi, Rukia Abdallah and Khadija Kassim, as well as all the study participants of the study. The authors gratefully acknowledge the contribution of funding from Australia’s National Health and Medical Research Council for the WHISPER or SHOUT trial (Project Grant GNT 1087006), Career Development Fellowships for SL, Senior Research Fellowship for MS and a Postgraduate Scholarship for FHA. The sponsor did not contribute to study design; data collection, analysis or interpretation; manuscript writing or the decision to submit the article for publication. Finally, we acknowledge the contribution of funding from the Victorian Operational Infrastructure Support Programme received by the Burnet Institute.
Publisher Copyright:
© 2022 BMJ Publishing Group. All rights reserved.
PY - 2022/10/7
Y1 - 2022/10/7
N2 - Introduction Prevalence of lifetime-induced abortion in female sex workers (FSWs) in Kenya was previously estimated between 43% and 86%. Our analysis aimed at assessing lifetime prevalence and correlates, and incidence and predictors of induced abortions among FSWs in Kenya. Methods This is a secondary prospective cohort analysis using data collected as part of the WHISPER or SHOUT cluster-randomised trial in Mombasa, assessing effectiveness of an SMS-intervention to reduce incidence of unintended pregnancy. Eligible participants were current FSWs, 16-34 years and not pregnant or planning pregnancy. Baseline data on self-reported lifetime abortion, correlates and predictors were collected between September 2016 and May 2017. Abortion incidence was measured at 6-month and 12-month follow-up. A multivariable logistic regression model was used to assess correlates of lifetime abortion and discrete-time survival analysis was used to assess predictors of abortions during follow-up. Results Among 866 eligible participants, lifetime abortion prevalence was 11.9%, while lifetime unintended pregnancy prevalence was 51.2%. Correlates of lifetime abortions were currently not using a highly effective contraceptive (adjusted OR (AOR)=1.76 (95% CI=1.11 to 2.79), p=0.017) and having ever-experienced intimate partner violence (IPV) (AOR=2.61 (95% CI=1.35 to 5.06), p=0.005). Incidence of unintended pregnancy and induced abortion were 15.5 and 3.9 per 100 women-years, respectively. No statistically significant associations were found between hazard of abortion and age, sex work duration, partner status, contraceptive use and IPV experience. Conclusion Although experience of unintended pregnancy remains high, lifetime prevalence of abortion may have decreased among FSW in Kenya. Addressing IPV could further decrease induced abortions in this population. Trial registration number ACTRN12616000852459.
AB - Introduction Prevalence of lifetime-induced abortion in female sex workers (FSWs) in Kenya was previously estimated between 43% and 86%. Our analysis aimed at assessing lifetime prevalence and correlates, and incidence and predictors of induced abortions among FSWs in Kenya. Methods This is a secondary prospective cohort analysis using data collected as part of the WHISPER or SHOUT cluster-randomised trial in Mombasa, assessing effectiveness of an SMS-intervention to reduce incidence of unintended pregnancy. Eligible participants were current FSWs, 16-34 years and not pregnant or planning pregnancy. Baseline data on self-reported lifetime abortion, correlates and predictors were collected between September 2016 and May 2017. Abortion incidence was measured at 6-month and 12-month follow-up. A multivariable logistic regression model was used to assess correlates of lifetime abortion and discrete-time survival analysis was used to assess predictors of abortions during follow-up. Results Among 866 eligible participants, lifetime abortion prevalence was 11.9%, while lifetime unintended pregnancy prevalence was 51.2%. Correlates of lifetime abortions were currently not using a highly effective contraceptive (adjusted OR (AOR)=1.76 (95% CI=1.11 to 2.79), p=0.017) and having ever-experienced intimate partner violence (IPV) (AOR=2.61 (95% CI=1.35 to 5.06), p=0.005). Incidence of unintended pregnancy and induced abortion were 15.5 and 3.9 per 100 women-years, respectively. No statistically significant associations were found between hazard of abortion and age, sex work duration, partner status, contraceptive use and IPV experience. Conclusion Although experience of unintended pregnancy remains high, lifetime prevalence of abortion may have decreased among FSW in Kenya. Addressing IPV could further decrease induced abortions in this population. Trial registration number ACTRN12616000852459.
KW - EPIDEMIOLOGY
KW - PUBLIC HEALTH
KW - SEXUAL MEDICINE
UR - http://www.scopus.com/inward/record.url?scp=85139571213&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-053218
DO - 10.1136/bmjopen-2021-053218
M3 - Article
C2 - 36207033
AN - SCOPUS:85139571213
SN - 2044-6055
VL - 12
JO - BMJ Open
JF - BMJ Open
IS - 10
M1 - e053218
ER -
