Biswas Aniruddha, Sadhukhan Sanjoy K, Pal Jayita, Pati Rama R, Ray Protim, Shaw Rajdeep, Saren Nilima
Epidemiology, All India Institute of Hygiene and Public Health, Kolkata, IND.
Maternal and Child Health, All India Institute of Hygiene and Public Health, Kolkata, IND.
Cureus. 2025 Jul 5;17(7):e87333. doi: 10.7759/cureus.87333. eCollection 2025 Jul.
Female sex workers (FSWs) face significant reproductive health challenges, including inconsistent condom use and high rates of unintended pregnancies and abortions. Understanding factors influencing these outcomes, particularly in rural brothel settings, is essential for targeted interventions.
A cross-sectional study was conducted among brothel-based FSWs in a rural region. Data on sociodemographic characteristics, sexual and contraceptive behaviors, and reproductive health outcomes were collected through structured interviews. Multivariate logistic regression was used to identify determinants of irregular condom use and abortion.
The study included 210 FSWs, aged 19-49 years (mean 29.3 ± 5.6). All reported consistent condom use with clients; however, only 25 (18.8%) used condoms regularly with cohabiting partners. Among those with irregular condom use in these relationships, 74 (64.4%) cited trust as the main reason. Condom breakage was reported by 177 participants (84.3%), with most responding by washing genitalia only, and only 6(3.5%) using emergency contraception. Multivariate analysis identified higher daily income (>₹2000) (AOR=2.22, 95% CI:1.12-4.40), history of STDs/reproductive tract infections (RTIs) (AOR=1.93, 95% CI:1.08-3.45), and condom breakage (AOR=2.49, 95% CI:1.10-5.64) as significant predictors of irregular condom use. Abortion was significantly associated with cohabitation (AOR=7.14, 95% CI:2.11-24.12), sex work duration ≥3.5 years (AOR=2.09, 95% CI:1.03-4.26), and sex without alcohol use (AOR=3.03, 95% CI:1.25-7.31).
Irregular condom use and abortion among rural FSWs are influenced by economic, behavioral, and relational factors. Interventions focusing on improving contraceptive access, counselling on dual protection, and addressing the dynamics of intimate partnerships are critical to enhancing reproductive health outcomes in this vulnerable group.
女性性工作者面临重大的生殖健康挑战，包括避孕套使用不规范以及意外怀孕和堕胎率高。了解影响这些结果的因素，尤其是在农村妓院环境中，对于有针对性的干预措施至关重要。
在一个农村地区对妓院中的女性性工作者进行了一项横断面研究。通过结构化访谈收集了社会人口学特征、性和避孕行为以及生殖健康结果的数据。采用多变量逻辑回归来确定避孕套使用不规范和堕胎的决定因素。
该研究纳入了210名年龄在19至49岁（平均29.3±5.6岁）的女性性工作者。所有人都报告与客户始终使用避孕套；然而，只有25人（18.8%）与同居伴侣定期使用避孕套。在这些关系中避孕套使用不规范的人中，74人（64.4%）将信任作为主要原因。177名参与者（84.3%）报告了避孕套破裂情况，大多数人仅通过清洗生殖器来应对，只有6人（3.5%）使用紧急避孕药。多变量分析确定日收入较高（>2000卢比）（调整后比值比[AOR]=2.22，95%置信区间[CI]：1.12 - 4.40）、性传播疾病/生殖道感染（RTIs）病史（AOR=1.93，95%CI：1.08 - 3.45）以及避孕套破裂（AOR=2.49，95%CI：1.10 - 5.64）是避孕套使用不规范的重要预测因素。堕胎与同居（AOR=7.14，95%CI：2.11 - 24.12）、性工作时长≥3.5年（AOR=2.09，95%CI：1.03 - 4.26）以及无酒精性行为（AOR=3.03，95%CI：1.25 - 7.31）显著相关。
农村女性性工作者中避孕套使用不规范和堕胎受到经济、行为和关系因素的影响。侧重于改善避孕措施获取、提供双重保护咨询以及解决亲密伴侣关系动态问题的干预措施对于改善这一弱势群体的生殖健康结果至关重要。
