"A Baby Was an Added Burden": Predictors and consequences of unintended pregnancies for female sex workers in Mombasa, Kenya: a mixed-methods study

 

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dc.contributor.author Luchters, Stanley en_ZA
dc.contributor.author Bosire, Wilkister en_ZA
dc.contributor.author Feng, Amy en_ZA
dc.contributor.author Richter, Marlise L en_ZA
dc.contributor.author King'ola, Nzioki en_ZA
dc.contributor.author Ampt, Frances en_ZA
dc.contributor.author Temmerman, Marleen en_ZA
dc.contributor.author Chersich, Matthew F en_ZA
dc.date.accessioned 2016-10-31T07:43:58Z
dc.date.available 2016-10-31T07:43:58Z
dc.date.issued 2016 en_ZA
dc.identifier.citation Luchters, S., Bosire, W., Feng, A., Richter, M. L., King’ola, N., Ampt, F., ... & Chersich, M. F. (2016)."A Baby Was an Added Burden": Predictors and consequences of unintended pregnancies for female sex workers in Mombasa, Kenya: a mixed-methods study. PloS one, 11(9), e0162871. doi:10.1371/journal.pone.0162871 en_ZA
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0162871 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/22378
dc.description.abstract Introduction Female sex workers (FSW) have high rates of unintended pregnancy, sexually transmitted infections including HIV, and other adverse sexual and reproductive health outcomes. Few services for FSWs include contraception. This mixed-methods study aimed to determine the rate, predictors and consequences of unintended pregnancy among FSWs in Mombasa, Kenya. METHODS: A prospective cohort study of non-pregnant FSWs was conducted. Quantitative data were collected quarterly, including a structured questionnaire and testing for pregnancy and HIV. Predictors of unintended pregnancy were investigated using multivariate logistic regression. Qualitative data were gathered through focus group discussions and in-depth interviews with FSWs who became pregnant during the study, and interviews with five key informants. These data were transcribed, translated and analysed thematically. RESULTS: Four hundred women were enrolled, with 92% remaining in the cohort after one year. Fifty-seven percent reported using a modern contraceptive method (including condoms when used consistently). Over one-third (36%) of women were using condoms inconsistently without another method. Twenty-four percent had an unintended pregnancy during the study. Younger age, having an emotional partner and using traditional or no contraception, or condoms only, were independent predictors of unintended pregnancy. Women attributed pregnancy to forgetting to use contraception and being pressured not to by clients and emotional partners, as well as "bad luck". They described numerous negative consequences of unintended pregnancy. CONCLUSION: Modern contraceptive uptake is surprisingly low in this at-risk population, which in turn has a high rate of unintended pregnancy. The latter may result in financial hardship, social stigma, risk of abandonment, or dangerous abortion practices. FSWs face considerable barriers to the adoption of dual method contraceptive use, including low levels of control in their emotional and commercial relationships. Reproductive health services need to be incorporated into programs for sexually transmitted infections and HIV, which address the socially-determined barriers to contraceptive use. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Pregnancy en_ZA
dc.subject.other Female contraception en_ZA
dc.subject.other Male contraception en_ZA
dc.subject.other Sex work en_ZA
dc.subject.other Termination of pregnancy en_ZA
dc.subject.other Contraception en_ZA
dc.subject.other Contraceptives en_ZA
dc.subject.other Sex workers en_ZA
dc.title "A Baby Was an Added Burden": Predictors and consequences of unintended pregnancies for female sex workers in Mombasa, Kenya: a mixed-methods study en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2016 Luchters et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image


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This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.