ArticleJournal of advanced nursing2023
Contraceptive decision-making through the lens of social determinants of health among female sex workers: A qualitative descriptive study.
Article in Journal of advanced nursing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 5 citations in OpenAlex.
- Social Determinants of Health and Patient-Reported Difficult Discontinuation of Long-Acting Reversible Contraception.Journal of women's health (2002) · 2024Article
- Socioeconomic determinants of male contraceptive use in South Africa: a secondary analysis of the 2016 SADHS data.BMC public health · 2024Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
aimsThe aim of the study was to examine how female sex worker's motivations, desires, intentions and behaviours towards childbearing and childbearing avoidance inform their contraceptive decision-making. We explored the influence of social determinants of health in the domains of social context (sexual partners and experiences of violence), healthcare access, economic instability on the contraceptive decision-making process.
designWe conducted a qualitative descriptive study informed by Miller's Theory of Childbearing Motivations, Desires and Intentions through the lens of social determinants of health.
methodsParticipants were recruited from a parent study, EMERALD, in July-September, 2020. Data were collected from 22 female sex workers ages 18-49 using semi-structured 45 to 60-min audio-recorded interviews and transcribed verbatim. Theory guided the development of the study's interview guide and thematic analytic strategy.
resultsFive themes emerged related to contraceptive decision-making: Motivations (value of fatherhood), Desires (relationships with love), Intentions and Behaviours (drugs overpower everything, contraceptive strategies and having children means being a protector). Women's contraceptive decision-making often included intentions to use contraception. However, social determinants such relationships with clients and intimate partners, interpersonal violence and challenges accessing traditional health care offering contraceptive services often interfered with these intentions and influenced contraceptive behaviours.
conclusionWomen's contraceptive decision-making process included well-informed desires related to childbearing and contraceptive use. However, social determinants across domains of health interfered with autonomous contraceptive decision-making. More effort is needed to examine the influence of social determinants on the reproductive health of this population. IMPACT: Findings from this study build on existing research that examines social determinants impacting reproductive health among female sex workers. Existing theoretical frameworks may not fully capture the influence constrained reproductive autonomy has on contraceptive decision-making. Future studies examining interpersonal and structural barriers to contraception are warranted. PATIENT OR PUBLIC CONTRIBUTION: The parent study, EMERALD, collaborated with community service providers in the study intervention.
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