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. 2019 Apr 8;19(1):121.
doi: 10.1186/s12884-019-2260-4.

Contraceptive use, prevalence and predictors of pregnancy planning among female sex workers in Uganda: a cross sectional study

Justine Nnakate Bukenya  1 , Rhoda K Wanyenze  2 , Geraldine Barrett  3 , Jennifer Hall  3 , Fredrick Makumbi  2 , David Guwatudde  2
Affiliations

Contraceptive use, prevalence and predictors of pregnancy planning among female sex workers in Uganda: a cross sectional study

Justine Nnakate Bukenya et al. BMC Pregnancy Childbirth. .

Abstract

Background: Unintended pregnancies are associated with negative consequences to both mother and baby. Female Sex Workers (FSWs) are at high risk of unintended/unplanned pregnancies. However, prevalence of pregnancy planning and its predictors among FSWs has not been comprehensively investigated. This study was designed to determine contraceptive use, the prevalence, and predictors of pregnancy planning among FSWs in Uganda.

Methods: In this cross-sectional study, 819 FSWs attending most at risk populations initiative (MARPI) clinics were recruited using systematic sampling and interviewed with a pretested questionnaire that included collection of data on pregnancy intention using the London Measure of Unplanned Pregnancy (LMUP). Data were analysed using STATA version 14.0. Multinomial logistic regression model was used to identify predictors of pregnancy planning, RESULTS: Of the 819 study participants, only 90 (11.0%) had planned pregnancies. Overall, 462 (56.4%) were hazardous alcohol users and 335 (40.9%) abused drugs; 172 (21.0%) had been raped in the last 2 years and 70 (40.7%) of these accessed emergency contraception post-rape. Dual contraception use (condom and other modern method) was 58.0%. Having a non-emotional partner as a man who impregnated the FSW compared to emotional partner was significantly associated with less planned relative to unplanned pregnancy, (aRR = 0.15 95%Cl =0.08, 0.30), so was lack of reported social support compared to support from friends, (aRR = 0.44; 95% CI = 0.22-0.87), keeping all factors constant in the model. Being raped (aRR = 0.51; 95% CI = 0.31-0.84) or abuse of substances (aRR = 0.65; 95% CI = 0.45-0.93) were significantly associated with lower ambivalence relative to unplanned pregnancy but not with planned relative to unplanned pregnancy.

Conclusion: Compared to women in the general population, pregnancy planning was low among FSWs amidst modest use of dual contraceptive. There is an urgent need to promote dual contraception among FSWs to prevent unplanned pregnancies especially with non-emotional partners, drug users, and post-rape.

Keywords: Female sex workers; Low income countries; Predictors; Pregnancy planning; Uganda.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by Makerere University School of Public Health Higher Degrees, Research and Ethics Committee and the Uganda National Council for Science and Technology (No: SS 4262). Permission to conduct the study was further sought from the MARPI Clinic managers and written informed consent was obtained from participants. Adolescents below age of 18 years were considered as emancipated minors and independently provided informed consent to participate in research as specified in the national guidelines [46]. Interviews were conducted in secluded locations within or outside facility premises to ensure client’s confidentiality. To ensure confidentiality of the data collected, no names were recorded on the data collection tool. Names were only recorded on consent forms, which were filed separately.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Distribution of LMUP scores among female sex workers attending MARPI Clinics
See this image and copyright information in PMC

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