Willis Brian, Perttu Emily, Fitzgerald Meghan, Thompson Heather, Weerasinghe Swarna, Macias-Konstantopoulos Wendy
Global Health Promise, Portland, OR, United States.
U.S. Overseas Cooperative Development Council, Washington DC, United States.
EClinicalMedicine. 2022 Sep 21;52:101658. doi: 10.1016/j.eclinm.2022.101658. eCollection 2022 Oct.
The vast majority of studies on female sex workers (FSW) focus on causes of morbidity while data on causes of mortality are scarce. In low- and middle-income countries, where civil registry and vital statistics data are often incomplete and FSW may not be identified as such in official registries, identifying causes of mortality among FSW has proven challenging.
As part of a larger investigation on the maternal health of FSW, the current study used the Community Knowledge Approach (CKA) to identify causes of mortality among FSW in LMIC across three global regions in 2019. The CKA, validated to identify maternal, neonatal, and jaundice-associated deaths among women living in a community, was employed to identify deaths of any cause among communities of FSW. Study participants, recruited by in-country partner non-governmental organizations (NGOs) working with local FSW, provided detailed information about FSW deaths in their communities.
1280 FSW participated in 165 group meetings through which 2112 FSW deaths were identified. Of these reported deaths, 57·9% occurred in 2019 and 57·2% were among women aged 20-29. Causes of death included abortion (35·5%), other maternal causes (16·6%), suicide (13·6%), murder (12·5%), unclassified causes (11·6%), HIV/AIDS (7·9%), and accidents (3·2%). A total of 3659 children lost their mothers.
Maternal death comprised the leading cause of FSW mortality in our sample. This methodology can be used by local governments and NGOs to identify unrecognized patterns and clusters of FSW deaths in near-real time and urgently steer targeted preventative strategies.
New Venture Fund.
绝大多数关于女性性工作者（FSW）的研究都集中在发病原因上，而关于死亡原因的数据却很稀少。在低收入和中等收入国家，民事登记和人口动态统计数据往往不完整，而且女性性工作者在官方登记中可能未被明确标识，因此确定女性性工作者的死亡原因颇具挑战性。
作为一项关于女性性工作者孕产妇健康的更大规模调查的一部分，本研究于2019年采用社区知识方法（CKA）来确定三个全球区域中低收入和中等收入国家女性性工作者的死亡原因。CKA已被验证可用于识别社区中女性的孕产妇、新生儿和黄疸相关死亡，此次被用于识别女性性工作者群体中的任何原因导致的死亡。研究参与者由与当地女性性工作者合作的国内合作伙伴非政府组织（NGO）招募，他们提供了所在社区女性性工作者死亡的详细信息。
1280名女性性工作者参加了165次小组会议，通过这些会议确定了2112例女性性工作者死亡案例。在这些报告的死亡案例中，57.9%发生在2019年，57.2%的死者年龄在20至29岁之间。死亡原因包括堕胎（35.5%）、其他孕产妇原因（16.6%）、自杀（13.6%）、谋杀（12.5%）、未分类原因（11.6%）、艾滋病毒/艾滋病（7.9%）和意外事故（3.2%）。共有3659名儿童失去了母亲。
在我们的样本中，孕产妇死亡是女性性工作者死亡的主要原因。地方政府和非政府组织可以使用这种方法近乎实时地识别未被认识到的女性性工作者死亡模式和集群，并紧急制定有针对性的预防策略。
新风险基金。
