Contraceptive practices, sexual and reproductive health needs of HIV-positive and negative female sex workers in Goa, India.
OBJECTIVE
In India, female sex workers (FSWs), suffer from high HIV prevalence and abortions. Contraceptive use among general population women is well understood. However, FSWs contraceptives practices and reproductive health needs are under-researched. We investigated contraceptive practices among HIV-positive and negative FSWs in Goa, India and explored its association with socio-demographic and sex work related factors.


METHODS
Cross-sectional study using respondent driven sampling recruited 326 FSWs. They completed an interviewer-administered questionnaire and were screened for STI/HIV. Multivariable logistic regression was used to explore factors associated with sterilisation relative to no contraception.


RESULTS
HIV prevalence was high (26%). Of the 59 FSWs planning pregnancy, 33% were HIV-positive and 5-7% had Gonorrhoea, Chlamydia and Trichomonas. 25% and 65% of FSWs screened-positive for Syphilis and Herpes simplex virus type 2 antibodies respectively. Among the 260 FSWs analysed for contraceptive use, 39% did not use contraceptives, and 26% had experienced abortion. Half the FSWs had undergone sterilisation, and only 5% used condoms for contraception. Among HIV-positive FSWs, 45% did not use contraceptives. Sterilisation was independently associated with older age, illiteracy, having an intimate non-paying male partner, having children and financial autonomy. Exposure to National AIDS Control Organisation's HIV-prevention interventions was reported by 34% FSWs and was not significantly associated with contraceptive use (adjusted odds ratio 1.4, 95% CI 0.7 to 2.9).


CONCLUSIONS
HIV-prevention interventions should promote contraception, especially among young and HIV-positive FSWs. Integrating HIV treatment and care services with HIV-prevention interventions is vital to avert HIV-positive births.
Wayal
Sonali
S
Positive People, Goa, India. sonaliwayal@yahoo.com
Cowan
Frances
F
Warner
Pamela
P
Copas
Andrew
A
Mabey
David
D
Shahmanesh
Maryam
M
D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior; D003270:Contraceptive Agents; D003430:Cross-Sectional Studies; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007194:India / Q000453:epidemiology; D020380:Needs Assessment; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D034121:Reproductive Health Services / Q000600:supply & distribution*; D011477:Sex Work / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013245:Sterilization, Reproductive / Q000706:statistics & numerical data; D055815:Young Adult
D003270:Contraceptive Agents