Positive People, Goa, India.
Sex Transm Infect. 2011 Feb;87(1):58-64. doi: 10.1136/sti.2010.043158. Epub 2010 Oct 27.
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.
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.
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).
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.
在印度，性工作者（FSWs）中 HIV 感染率和堕胎率都很高。一般人群中女性的避孕措施使用情况已有充分了解。然而，FSWs 的避孕措施和生殖健康需求研究不足。我们调查了印度果阿邦 HIV 阳性和阴性 FSWs 的避孕措施，并探讨了其与社会人口学和性工作相关因素的关系。
采用应答者驱动抽样的横断面研究招募了 326 名 FSWs。她们完成了一份由调查员管理的问卷，并接受了性传播感染/艾滋病毒筛查。多变量逻辑回归用于探讨与绝育相比不采取避孕措施的相关因素。
HIV 感染率很高（26%）。在计划怀孕的 59 名 FSWs 中，33%为 HIV 阳性，5-7%患有淋病、衣原体和滴虫病。25%和 65%的 FSWs 梅毒和单纯疱疹病毒 2 抗体筛查阳性。在分析的 260 名 FSWs 中，39%不使用避孕药，65%经历过堕胎。一半的 FSWs已经绝育，只有 5%使用避孕套避孕。在 HIV 阳性 FSWs 中，45%不使用避孕药。绝育与年龄较大、文盲、有非付费的亲密男性伴侣、有子女和经济独立独立相关。34%的 FSWs 报告接触过国家艾滋病控制组织的 HIV 预防干预措施，但与避孕措施使用无显著关联（调整后的优势比 1.4，95%置信区间 0.7 至 2.9）。
HIV 预防干预措施应促进避孕措施的使用，特别是在年轻和 HIV 阳性的 FSWs 中。将 HIV 治疗和护理服务与 HIV 预防干预措施相结合，对于避免 HIV 阳性产妇至关重要。
