Caitlin E Martin1, Andrea L Wirtz2, Vladimir Mogilniy3, Alena Peryshkina3, Chris Beyrer4, Michele R Decker5. 1. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 2. Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Emergency Medicine, Johns Hopkins Medical Institute, Baltimore, MD, USA. 3. AIDS Infoshare, Moscow, Russia. 4. Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 5. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: mdecker@jhsph.edu.
Abstract
OBJECTIVE: To determine the prevalence of, and factors associated with, use of non-barrier contraception (intrauterine device, hormonal contraceptives, and female sterilization) among female sex workers (FSWs) in three Russian cities. METHODS: A secondary analysis of data from a cross-sectional survey of FSWs aged 18 years and older from Kazan, Krasnoyarsk, and Tomsk was undertaken. Participants had completed a one-time computer-based survey in 2011. Among the 708 with a current contraceptive need, logistic regression was used to evaluate factors associated with use of non-barrier contraceptives. RESULTS: Use of non-barrier contraceptives was reported by 237 (33.5%) FSWs. Use of non-barrier contraceptives was associated with being in sex work longer (≥ 4 years vs < 1 year: adjusted odds ratio [AOR] 4.70; 95% confidence interval [CI] 1.51-14.66) and having a non-paying partner (AOR 2.02; 95% CI 1.32-3.11). Odds of non-barrier contraception were reduced among FSWs who had ever worked with a pimp/momka (AOR 0.46; 95% CI 0.24-0.87), who had experienced recent client-perpetrated violence (AOR 0.19; 95% CI 0.07-0.52), or reporting consistent condom use (AOR 0.30; 95% CI 0.16-0.54). Only 13 (5.5%) of the 237 FSWs using non-barrier contraception reported consistent condom use. CONCLUSION: Only one-third reported use of non-barrier contraception, suggesting substantial unmet contraceptive needs. FSWs are an important target population for family planning, reproductive health counseling, and care.
OBJECTIVE: To determine the prevalence of, and factors associated with, use of non-barrier contraception (intrauterine device, hormonal contraceptives, and female sterilization) among female sex workers (FSWs) in three Russian cities. METHODS: A secondary analysis of data from a cross-sectional survey of FSWs aged 18 years and older from Kazan, Krasnoyarsk, and Tomsk was undertaken. Participants had completed a one-time computer-based survey in 2011. Among the 708 with a current contraceptive need, logistic regression was used to evaluate factors associated with use of non-barrier contraceptives. RESULTS: Use of non-barrier contraceptives was reported by 237 (33.5%) FSWs. Use of non-barrier contraceptives was associated with being in sex work longer (≥ 4 years vs < 1 year: adjusted odds ratio [AOR] 4.70; 95% confidence interval [CI] 1.51-14.66) and having a non-paying partner (AOR 2.02; 95% CI 1.32-3.11). Odds of non-barrier contraception were reduced among FSWs who had ever worked with a pimp/momka (AOR 0.46; 95% CI 0.24-0.87), who had experienced recent client-perpetrated violence (AOR 0.19; 95% CI 0.07-0.52), or reporting consistent condom use (AOR 0.30; 95% CI 0.16-0.54). Only 13 (5.5%) of the 237 FSWs using non-barrier contraception reported consistent condom use. CONCLUSION: Only one-third reported use of non-barrier contraception, suggesting substantial unmet contraceptive needs. FSWs are an important target population for family planning, reproductive health counseling, and care.
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