TY - JOUR
T1 - Female sex workers experiences of using contraceptive methods
T2 - A qualitative study in Kenya
AU - Ochako, Rhoune
AU - Okal, Jerry
AU - Kimetu, Steven
AU - Askew, Ian
AU - Temmerman, Marleen
N1 - Publisher Copyright:
© 2018 The Author(s).
PY - 2018/6/20
Y1 - 2018/6/20
N2 - Background: Female Sex Workers (FSWs) are predisposed to a broad range of social, sexual and reproductive health problems such as sexually transmitted infections (STIs)/HIV, unintended pregnancy, violence, sexual exploitation, stigma and discrimination. Female sex workers have unmet need for contraceptives and require comprehensive Sexual and Reproductive Health (SRH) prevention interventions. Existing programs pay little attention to the broad sexual and reproductive health and rights of these women and often focus on HIV and other STIs prevention, care and treatment while neglecting their reproductive health needs, including access to family planning methods. The aim of this study is, therefore, to explore the experiences of female sex workers with using existing contraceptive methods, assess individual and health facility-level barriers and document inter-partner relationship in the use of contraceptives. Methods: We focus on women aged 15-49, who reported current sex work, defined as 'providing sexual services in exchange for money or other material compensation as part of an individual's livelihood.' Results: Findings reveal that while some FSWs know about modern contraceptives, others have limited knowledge or out rightly refuse to use contraceptives for fear of losing clients. The interaction with different client types act as a barrier but also provide an opportunity for contraceptive use among FSWs. Most FSWs recognize the importance of dual protection for HIV/STI and pregnancy prevention. However, myths and misconceptions, fear of being tested for HIV at the family planning clinic, wait time, and long queues at the clinics all act in combination to hinder uptake of contraceptives. Conclusions: We recommend a targeted approach to address the contraceptive needs of FSWs to help remove barriers to contraceptive uptake. We also support the introduction of counseling services to provide information on the benefits of non-barrier contraceptive methods and thereby enhance dual use for both pregnancy and STI/HIV prevention.
AB - Background: Female Sex Workers (FSWs) are predisposed to a broad range of social, sexual and reproductive health problems such as sexually transmitted infections (STIs)/HIV, unintended pregnancy, violence, sexual exploitation, stigma and discrimination. Female sex workers have unmet need for contraceptives and require comprehensive Sexual and Reproductive Health (SRH) prevention interventions. Existing programs pay little attention to the broad sexual and reproductive health and rights of these women and often focus on HIV and other STIs prevention, care and treatment while neglecting their reproductive health needs, including access to family planning methods. The aim of this study is, therefore, to explore the experiences of female sex workers with using existing contraceptive methods, assess individual and health facility-level barriers and document inter-partner relationship in the use of contraceptives. Methods: We focus on women aged 15-49, who reported current sex work, defined as 'providing sexual services in exchange for money or other material compensation as part of an individual's livelihood.' Results: Findings reveal that while some FSWs know about modern contraceptives, others have limited knowledge or out rightly refuse to use contraceptives for fear of losing clients. The interaction with different client types act as a barrier but also provide an opportunity for contraceptive use among FSWs. Most FSWs recognize the importance of dual protection for HIV/STI and pregnancy prevention. However, myths and misconceptions, fear of being tested for HIV at the family planning clinic, wait time, and long queues at the clinics all act in combination to hinder uptake of contraceptives. Conclusions: We recommend a targeted approach to address the contraceptive needs of FSWs to help remove barriers to contraceptive uptake. We also support the introduction of counseling services to provide information on the benefits of non-barrier contraceptive methods and thereby enhance dual use for both pregnancy and STI/HIV prevention.
KW - Condom use
KW - Contraception
KW - FSWs
KW - Kenya
KW - Pregnancy prevention
UR - http://www.scopus.com/inward/record.url?scp=85048872423&partnerID=8YFLogxK
U2 - 10.1186/s12905-018-0601-5
DO - 10.1186/s12905-018-0601-5
M3 - Article
C2 - 29925361
AN - SCOPUS:85048872423
SN - 1472-6874
VL - 18
JO - BMC Women's Health
JF - BMC Women's Health
IS - 1
M1 - 105
ER -