Characteristics, risk behaviors and factors associated with abortion among female entertainment workers in Cambodia.
BACKGROUND
Linkages between HIV and reproductive health (RH) among female entertainment workers (EWs) have not been addressed well in most developing countries. In Cambodia, there has been considerable research on HIV epidemiology among EWs. However, there have been limited studies on RH and specifically factors related to abortion. We examine socio-behavioral characteristics, and RH practices as determinants of abortion among Cambodian EWs.


METHODS
A survey was conducted in Siem Reap and Battambang and Phnom Penh provinces/city among EWs in September 2012. Trained female interviewers administered the survey to 595 EWs. Two-stage cluster sampling was used to select EWs. Bivariate associations were examined using chi-squares; univariate and multivariate logistic regression were used to assess factors independently associated with reporting having at least one abortion while working as an EW.


RESULTS
Three-quarters (75 %) of EWs were sexually active, of which nearly one third reported at least one abortion while working as an EW. About 40 % of EWs reported recent an abortion in the past six months. Contraceptive use in the past year was low. Factors found to be independently associated with reporting a recent abortion included: ages 25-29 (OR = 2.2, 95 % CI: 1.2-4.0), living with spouse/cohabitated partner (OR = 2.2, 95 % CI: 1.1-4.2), longer duration of entertainment work (OR = 4.8, 95 % CI: 2.5-9.2), higher number of partners (OR = 4.4, 95 % CI: 2.2-8.7) and being a karaoke worker (OR = 2.2, 95 % CI: 1.1-4.4).


CONCLUSIONS
This study highlights a high proportion of EWs reporting abortion. While HIV vulnerability of EWs has been clearly established, broader RH needs have gone largely unrecognized and not prioritized. Though HIV/RH integrated initiatives have been introduced by the HIV program, challenges for EWs with multiple risks from professional and partners are profound. Therefore, there is an urgent need for practical programmatic approaches to help address their RH needs.
School of Public Health at the National Institute of Public Health, Cambodia, # 2, Street 289, Tuol Kork District, Phnom Penh, Cambodia. hsopheab2002@gmail.com.
Heng
H
Sopheab
Research Department, KHANA, Phnom Penh, Cambodia. tsovannary@khana.org.kh.
Sovannary
S
Tuot
School of Public Health at the National Institute of Public Health, Cambodia, # 2, Street 289, Tuol Kork District, Phnom Penh, Cambodia. cchhorvann@niph.org.kh.
Chhorvann
C
Chhea
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, USA. pgorbach@ucla.edu.
Pamina
P
Gorbach
D000028:Abortion, Induced / Q000009:adverse effects* / Q000706:statistics & numerical data; D000328:Adult; D002160:Cambodia; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D013997:Time Factors