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Pregnancy intentions among female sex workers: recognising their rights and wants as mothers
  1. Putu Duff1,
  2. Jeannie Shoveller2,
  3. Cindy Feng3,
  4. Gina Ogilvie4,
  5. Julio Montaner5,
  6. Kate Shannon6
  1. 1Research Assistant and PhD Candidate, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver and School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Professor, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Assistant Professor, School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  4. 4Associate Director of the Division of STI/HIV Prevention, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
  5. 5Director, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver and Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, British Columbia, Canada
  6. 6Associate Professor and Director of the Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver; School of Population and Public Health, University of British Columbia, Vancouver; and Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Kate Shannon, Department of Medicine, University of British Columbia, Gender and Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, British Columbia, Canada V6Z 1Y6; gshi{at}cfenet.ubc.ca

Abstract

Objective To better understand the prevalence and correlates of pregnancy intentions among female sex workers (FSWs).

Design Cross-sectional analysis using data from an open prospective cohort of street and off-street FSWs in Vancouver, Canada, in partnership with local sex work and community agencies.

Methods FSWs were recruited through outreach to street and off-street locations (e.g. massage parlours, micro-brothels) and completed interviewer-administered questionnaires and HIV/sexually transmitted infection testing. Bivariable and multivariable logistic regression was used to evaluate correlates of pregnancy intention, based on a ‘yes’ or ‘no’ response to the question “Are you planning on have any (any more) children in the future?”.

Results Of the 510 women, 394 (77.3%) reported prior pregnancy, with 140 (27.5%) of the entire sample reporting positive pregnancy intentions. Regarding ethnicity, 35.3% were Caucasian and 26.3% were Asian/visible minority, with no differences in pregnancy intention by ethnicity or HIV status; 38.4% reported Canadian Aboriginal ancestry. In our final multivariable model, servicing clients in formal indoor settings, inconsistent condom use by clients, younger age, and intimate partner violence (IPV) were associated with pregnancy intention.

Conclusions FSWs may have pregnancy intention levels similar to that of women in other occupations. Policy changes are needed to improve FSWs’ access to integrated HIV and reproductive health services and harm reduction services, particularly for FSWs experiencing IPV.

  • pregnancy intentions
  • reproductive health
  • contraception
  • sex work
  • HIV
  • fertility

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