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Structural determinants of dual contraceptive use among female sex workers in Gulu, northern Uganda
Author(s) -
Erickson Margaret,
Goldenberg Shira M.,
Ajok Mirriam,
Muldoon Katherine A.,
Muzaaya Godfrey,
Shan Kate
Publication year - 2015
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 - 10.1016/j.ijgo.2015.04.029
Subject(s) - medicine , unintended pregnancy , demography , reproductive health , sex work , logistic regression , cross sectional study , population , odds ratio , outreach , condom , pregnancy , confidence interval , gynecology , family planning , environmental health , family medicine , human immunodeficiency virus (hiv) , syphilis , research methodology , pathology , sociology , political science , law , biology , genetics
Objective To describe the characteristics of female sex workers (FSWs) who do and do not use dual contraceptives (i.e. male condoms plus a non‐barrier method) in Gulu, northern Uganda. Methods The present analysis was based on data gathered as part of a questionnaire‐based, cross‐sectional study conducted between May 2011 and January 2012. FSWs aged 14 years or older were recruited through peer‐led or sex worker‐led outreach and community‐based services. Logistic regression was used to identify correlates of dual contraceptive use. Results Among the 400 FSWs who participated, 180 (45.0%) had ever used dual contraceptives. In the multivariate model, dual contraceptive use was positively associated with older age (adjusted odds ratio [AOR] 1.09, 95% confidence interval [CI] 1.04–1.15; P = 0.001), prior unintended pregnancy (AOR 1.53, 95% CI 1.01–2.34; P = 0.046), and HIV testing (AOR 5.22, 95% CI 1.75–15.57; P = 0.003). Having to rush sexual negotiations owing to police presence was negatively associated with dual contraceptive use (AOR 0.65, 95% CI 0.42–1.00; P = 0.050). Conclusion Although a history of unintended pregnancy and accessing HIV testing might promote contraceptive use, criminalized work environments continue to pose barriers to uptake of sexual and reproductive health services among FSWs in post‐conflict northern Uganda. Integrated links between HIV and sexual health programs could support contraceptive uptake among FSWs.