柬埔寨女性娱乐工作者中与人工流产相关的因素：一项横断面研究
Factors associated with induced abortion among female entertainment workers: a cross-sectional study in Cambodia.
作者信息
Yi Siyan, Tuot Sovannary, Chhoun Pheak, Pal Khuondyla, Tith Khimuy, Brody Carinne
机构信息
Research Center, KHANA, Phnom Penh, Cambodia Center for Global Health Research, Public Health Program, Touro University California, Vallejo, California, USA.
Research Center, KHANA, Phnom Penh, Cambodia.
出版信息
BMJ Open. 2015 Jul 31;5(7):e007947. doi: 10.1136/bmjopen-2015-007947.
OBJECTIVE
To explore risk factors associated with induced abortion among sexually active female entertainment workers (FEWs) in Cambodia.
DESIGN
Cross-sectional study.
SETTING
Phnom Penh and Siem Reap, Cambodia.
PARTICIPANTS
This study included 556 FEWs aged 18-47 years randomly selected from entertainment establishments in the two cities in 2014 using a two-stage cluster sampling method. Data were collected through face-to-face interviews using a structured questionnaire.
PRIMARY OUTCOME MEASURE
History of induced abortion during the time working as a FEW.
RESULTS
Of the total sample, 45.6% reported currently using a contraceptive method with condom (42.4%) being the most common method, followed by pills (25.6%). One-fourth (25%) of the respondents reported having been pregnant at least once, and 21.4% reported having at least one induced abortion during the time working as a FEW. After controlling for other covariates in a multivariate logistic regression model, FEWs with a history of induced abortion remained significantly more likely to be currently working in a karaoke bar (AOR=1.75, 95% CI 1.10 to 2.78), to have worked longer as a FEW (AOR=1.42, 95% CI 1.06 to 1.43), to have had a greater number of sexual partners in the past 12 months (AOR=1.86, 95% CI 1.02 to 1.54), to be currently using a contraceptive method (AOR=1.52, 95% CI 1.01 to 2.29), to be able to find condoms when they needed them (AOR=2.03, 95% CI 1.09 to 3.82), and to report inconsistent condom use with non-commercial partners in the past 3 months (AOR=1.62, 95% CI 1.06 to 3.44).
CONCLUSIONS
This study highlights the high rates of unwanted pregnancies that ended in induced abortions among FEWs in Cambodia. Access of FEWs to quality sexual and reproductive healthcare services is deemed a high priority. Integrated interventions to improve sexual and reproductive health among these vulnerable women should be tailored to reach the most-at-risk groups.
目的
探讨柬埔寨性活跃女性娱乐工作者（FEWs）人工流产的相关危险因素。
设计
横断面研究。
地点
柬埔寨金边和暹粒。
参与者
本研究于2014年采用两阶段整群抽样方法，从这两个城市的娱乐场所中随机选取了556名年龄在18 - 47岁的女性娱乐工作者。通过使用结构化问卷进行面对面访谈收集数据。
主要观察指标
女性娱乐工作者从业期间的人工流产史。
结果
在总样本中，45.6%报告目前使用避孕方法，其中避孕套（42.4%）是最常用的方法，其次是避孕药（25.6%）。四分之一（25%）的受访者报告至少怀孕过一次，21.4%报告在女性娱乐工作者从业期间至少有过一次人工流产。在多因素logistic回归模型中控制其他协变量后，有过人工流产史的女性娱乐工作者目前仍更有可能在卡拉OK酒吧工作（比值比[AOR]=1.75，95%置信区间[CI]为1.10至2.78），从业时间更长（AOR=1.42，95%CI为1.06至1.43），在过去12个月内有更多性伴侣（AOR=1.86，95%CI为1.02至1.54），目前正在使用避孕方法（AOR=1.52，95%CI为1.01至2.29），在需要时能够找到避孕套（AOR=2.03，95%CI为1.09至3.82），以及报告在过去3个月内与非商业性伴侣使用避孕套情况不一致（AOR=1.62，95%CI为1.06至3.44）。
结论
本研究凸显了柬埔寨女性娱乐工作者中意外怀孕并最终导致人工流产的高发生率。为女性娱乐工作者提供高质量的性与生殖健康保健服务被视为高度优先事项。应针对这些脆弱女性群体中风险最高的人群量身定制综合干预措施，以改善其性与生殖健康。
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