INTRODUCTION

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.