Wahed Tasnuva, Alam Anadil, Sultana Salima, Alam Nazmul, Somrongthong Ratana
College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
Research to policy Limited, Mirpur, Dhaka, Bangladesh.
PLoS One. 2017 Apr 3;12(4):e0174540. doi: 10.1371/journal.pone.0174540. eCollection 2017.
The objective of this study was to document sexual and reproductive health (SRH) practices among female sex workers (FSWs) including abortion, pregnancy, use of maternal healthcare services and sexually transmitted infections (STIs) with the aim of developing recommendations for action.
A total of 731 FSWs aged between 15 and 49 years were surveyed using a stratified sampling in Dhaka, Bangladesh. A workshop with 23 participants consisted of policy makers, researchers, program implementers was conducted to formulate recommendations.
About 61.3% of 731 FSWs reported SRH-related experiences in the past one year, including abortion (15.5%), ongoing pregnancy (9.0%), childbirth (8.3%) or any symptoms of STIs (41.6%). Among FSWs who had an abortion (n = 113), the most common methods included menstrual regulation through manual vacuum aspiration (47.8%), followed by Dilation and Curettage procedure (31%) and oral medicine from pharmacies (35.4%). About 57.5% of 113 cases reported post abortion complications. Among FSWs with delivery in the past year (n = 61), 27.7% attended the recommended four or more antenatal care visits and more than half did not have any postnatal visit. Adopting sustainable and effective strategies to provide accessible and adequate SRH services for FSWs was prioritized by workshop participants.
There was substantial unmet need for SRH care among FSWs in urban areas in Dhaka, Bangladesh. Therefore, it is important to integrate SRH services for FSWs in the formal healthcare system or integration of abortion and maternal healthcare services within existing HIV prevention services.
本研究的目的是记录女性性工作者的性与生殖健康实践情况，包括堕胎、怀孕、孕产妇保健服务的使用以及性传播感染情况，以便制定行动建议。
在孟加拉国达卡，采用分层抽样法对731名年龄在15至49岁之间的女性性工作者进行了调查。举办了一次有23名参与者（包括政策制定者、研究人员、项目实施者）参加的研讨会，以制定建议。
在731名女性性工作者中，约61.3%报告在过去一年中有与性与生殖健康相关的经历，包括堕胎（15.5%）、正在怀孕（9.0%）、分娩（8.3%）或任何性传播感染症状（41.6%）。在有过堕胎经历的女性性工作者（n = 113）中，最常见的方法包括人工负压吸引术进行月经调节（47.8%），其次是刮宫术（31%）和从药店购买口服药（35.4%）。113例中有约57.5%报告了堕胎后并发症。在过去一年中有分娩经历的女性性工作者（n = 61）中，27.7%接受了建议的四次或更多次产前检查，超过一半的人没有进行任何产后检查。研讨会参与者优先考虑采取可持续和有效的策略，为女性性工作者提供可及且充分的性与生殖健康服务。
在孟加拉国达卡的城市地区，女性性工作者对性与生殖健康护理的需求存在大量未得到满足的情况。因此，将女性性工作者的性与生殖健康服务纳入正规医疗保健系统，或将堕胎和孕产妇保健服务纳入现有的艾滋病毒预防服务中非常重要。
