ArticlePloS one2019
Prevalence and predictors of unmet contraceptive need in HIV-positive female sex workers in Mombasa, Kenya.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Unmet need for family planning among reproductive-age women living with HIV in Africa: a systematic review and meta-analysis.BMC women's health · 2026Pooled it
- Health inequities faced by sex workers.The Lancet. Public health · 2026Review
- Unmet need for family planning among married women in sub-Saharan Africa: a meta-analysis of DHS data (1995 - 2020).Contraception and reproductive medicine · 2023Article
- Understanding the factors associated with HIV and STIs diagnosis among Black heterosexual men in Ottawa and Windsor, Ontario.Journal of public health research · 2022Article
- Barriers and facilitators for access and utilization of reproductive and sexual health services among Female Sex Workers in urban and rural Maharashtra, India.Frontiers in public health · 2022Article
- Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review of Non-Barrier Contraception, Pregnancy and Abortion.Public health reviews · 2022Article
- Values and preferences of contraceptive methods: a mixed-methods study among sex workers from diverse settings.Sexual and reproductive health matters · 2021Article
- Future directions for HIV service delivery research: Research gaps identified through WHO guideline development.PLoS medicine · 2021Article
- Unmet contraceptive needs among female sex workers (FSWs) in semi urban Blantyre, Malawi.Reproductive health · 2021Article
- Unmet Need for Contraception Among Female Sex Workers Initiating Oral Pre-Exposure Prophylaxis for HIV Prevention During Kenya's National Scale-Up: Results From a Programmatic Surveillance Study.Frontiers in global women's health · 2021Article
- Integrating Sexual and Reproductive Health Services Within HIV Services: WHO Guidance.Frontiers in global women's health · 2021Article
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesFemale sex workers (FSWs) in sub-Saharan Africa are a key population for HIV prevention and treatment interventions, but less attention is given to their family planning needs. We evaluated the prevalence and predictors of unmet contraceptive need in HIV-positive FSWs. STUDY
designThis cross-sectional analysis used data from an existing longitudinal study of FSWs in Mombasa, Kenya. This analysis included women who were HIV positive, age ≥18 years, pre-menopausal, not currently pregnant or desiring pregnancy, and reported exchanging sex for cash or in-kind payment at the time of enrollment. Unmet contraceptive need was defined as non-use of modern non-barrier contraceptives and not currently trying to become pregnant. Poisson regression was used to identify factors independently associated with unmet contraceptive need.
resultsAmong 346 HIV-positive FSWs, 125 (36.1%) reported modern non-barrier contraceptive use, leaving 221 (63.9%, 95%CI 58.8-68.9%) with unmet contraceptive need. Condom use was the only form of contraception for 129 (37.3%) participants. In unadjusted analyses, unmet contraceptive need was associated with physical abuse in the past year by someone other than a regular partner (PR 1.2, 95%CI 1.0-1.5), desire for (more) children (PR 1.3, 95%CI 1.1-1.5), and having 2-3 previous pregnancies compared to 0-1 prior pregnancies (PR 0.8, 95%CI 0.6-0.9). In adjusted analyses, lower number of previous pregnancies and having desire for future children remained significantly associated with a higher prevalence of unmet contraceptive need.
conclusionsUnmet need for modern non-barrier contraception was found in two-thirds of HIV-positive FSWs who reported that they were not currently trying to become pregnant, and was higher in women with the lowest number of prior pregnancies (0-1 prior pregnancies) and in those reporting desire for (more) children in the future. These findings highlight the need for concerted efforts to identify and eliminate barriers to contraceptive use in FSWs living with HIV.
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