Noah Jean-Pierre Yves Awono, Ndié Justin, Muluh Clifford, Dongmo Rogacien Kana, Ndongo Francis Ateba, Tabala Félicité Naah, De Dieu Anoubissi Jean, Tedongmo Martial Guengang, Wepnyu Yembe Njamnshi, Bonyohe Martial Aimé, Metambou Jaures, Heuya Yvette Ndjatte, Akiy Zacheaus Zeh, Ebongue Iris Kuoh, Angumua Carrine, Meka Albert Zeh, Keugoung Basile, Fokam Joseph, Ateudjieu Jérôme, Bissek Anne Cécile Zoung-Kanyi
Division of Operational Research in Health/Ministry of Public Health, Yaoundé, Cameroon.
UNICEF, Yaoundé, Cameroon.
BMC Public Health. 2025 Jul 28;25(1):2564. doi: 10.1186/s12889-025-23736-7.
BACKGROUND: Sub-Saharan Africa has a high prevalence of pregnancy among female sex workers (FSWs). Understanding FSWs' pregnancy intentions and how they affect pregnancies can help prevent unintended pregnancies (UP) and poor pregnancy outcome. This study investigates factors associated with pregnancy and outcomes among FSWs in Cameroon. METHODS: A cross-sectional study was conducted in FSWs aged 18 to 49 years. Participants were recruited through voluntary sampling in eight community-based organisations across five towns in Cameroon during July 2023. The three outcomes were pregnancy, UP and poor pregnancy outcome within the last twelve months. A binary logistic regression using SPSS 27 with backward Wald's method and Robust (modified) Poisson Regression was performed to identify factors associated with the outcomes of interest. RESULTS: A total of 481 female sex workers (FSWs) with a median age of 24 years were recruited for the study. Among them, 101 (21%) experienced at least one pregnancy during the last twelve months, of which 34 (33.7%) was UP. Among those who reported pregnancy, 53.5% (54/101) had a live birth versus 20.6% (7/34) for those who experienced UP. FSWs aged > = 25 years (Vs < = 24 years) were less likely to experience pregnancy (aOR = 0.49, 95% CI: 0.29-0.83) and those who abuse of at least one psychoactive substance (PAS) were more likely to have at least one pregnancy (aOR = 1.91, 95% CI: 1.002-3.65). UP was lower among those who had another source of income than prostitution (aRR = 0.39, 95% CI: 0.15-0.98). The risk of poor pregnancy outcome increases by almost 3 (aRR = 2.66, 95% CI: 1.76-4.00) for FSWs who faced UP. CONCLUSION: Among FSWs in Cameroon, younger age (< 25 years), positive pregnancy intention, and psychoactive substance use were all significantly associated with higher odds of experiencing pregnancy in the past twelve months. Additionally, unintended pregnancy more than doubled the risk of a poor pregnancy outcome (abortion or miscarriage). These findings underscore the urgent need for targeted interventions promoting consistent contraceptive use and addressing substance use-especially among younger FSWs who intend pregnancy-to reduce unintended pregnancies and related adverse outcomes.
背景：撒哈拉以南非洲地区女性性工作者（FSW）的怀孕率很高。了解FSW的怀孕意愿及其对怀孕的影响有助于预防意外怀孕（UP）和不良妊娠结局。本研究调查了喀麦隆FSW中与怀孕及结局相关的因素。 方法：对年龄在18至49岁的FSW进行了一项横断面研究。2023年7月期间，通过在喀麦隆五个城镇的八个社区组织中进行自愿抽样招募参与者。三个结局分别是过去十二个月内的怀孕、UP和不良妊娠结局。使用SPSS 27采用向后 Wald 法进行二元逻辑回归，并进行稳健（修正）泊松回归，以确定与感兴趣结局相关的因素。 结果：共招募了481名中位年龄为24岁的女性性工作者进行研究。其中，101人（21%）在过去十二个月内经历了至少一次怀孕，其中34人（33.7%）为UP。在报告怀孕的人中，53.5%（54/101）活产，而经历UP的人中这一比例为20.6%（7/34）。年龄≥25岁的FSW（对比≤24岁）怀孕的可能性较小（调整后比值比[aOR]=0.49，95%置信区间[CI]：0.29 - 0.83），而滥用至少一种精神活性物质（PAS）的人怀孕的可能性更大（aOR = 1.91，95% CI：1.002 - 3.65）。有除卖淫以外其他收入来源的人UP发生率较低（调整后风险比[aRR]=0.39，95% CI：0.15 - 0.98）。经历UP的FSW出现不良妊娠结局的风险增加近3倍（aRR = 2.66，95% CI：1.76 - 4.00）。 结论：在喀麦隆的FSW中，年龄较小（<25岁）、积极的怀孕意愿和使用精神活性物质均与过去十二个月内怀孕几率较高显著相关。此外，意外怀孕使不良妊娠结局（流产或堕胎）的风险增加了一倍多。这些发现强调迫切需要采取有针对性的干预措施，促进持续使用避孕药具并解决物质使用问题，尤其是在有怀孕意愿的年轻FSW中，以减少意外怀孕及相关不良结局。
Cochrane Database Syst Rev. 2016-2-3
Cochrane Database Syst Rev. 2016-3-30
Cochrane Database Syst Rev. 2016-6-29
Cochrane Database Syst Rev. 2008-7-16
BMC Pregnancy Childbirth. 2024-11-28
Fertil Steril. 2023-11
Trop Med Health. 2023-8-16
Zotero 插件
