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Use of long‐acting reversible contraception in a cluster‐random sample of female sex workers in Kenya
Author(s) -
Ampt Frances H.,
Lim Megan S.C.,
Agius Paul A.,
Chersich Matthew F.,
Manguro Griffins,
Gichuki Caroline M.,
Stoové Mark,
Temmerman Marleen,
Jaoko Walter,
Hellard Margaret,
Gichangi Peter,
Luchters Stanley
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12862
Subject(s) - medicine , cluster (spacecraft) , sample (material) , female sex , chemistry , chromatography , computer science , programming language
Abstract Objective To assess correlates of long‐acting reversible contraceptive (LARC) use, and explore patterns of LARC use among female sex workers (FSWs) in Kenya. Methods Baseline cross‐sectional data were collected between September 2016 and May 2017 in a cluster‐randomized controlled trial in Mombasa. Eligibility criteria included current sex work, age 16–34 years, not pregnant, and not planning pregnancy. Peer educators recruited FSWs from randomly selected sex‐work venues. Multiple logistic regression identified correlates of LARC use. Prevalence estimates were weighted to adjust for variation in FSW numbers recruited across venues. Results Among 879 participants, the prevalence of contraceptive use was 22.6% for implants and 1.6% for intra‐uterine devices (IUDs). LARC use was independently associated with previous pregnancy (adjusted odds ratio for one pregnancy, 11.4; 95% confidence interval, 4.25–30.8), positive attitude to and better knowledge of family planning, younger age, and lower education. High rates of adverse effects were reported for all methods. Conclusion The findings suggest that implant use has increased among FSWs in Kenya. Unintended pregnancy risks remain high and IUD use is negligible. Although LARC rates are encouraging, further intervention is required to improve both uptake (particularly of IUDs) and greater access to family planning services.