Sexual and reproductive health outcomes among female sex workers in Johannesburg and Pretoria, South Africa: Recommendations for public health programmesReportar como inadecuado




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BMC Public Health

, Volume 17, Supplement 3, pp 17–27

First Online: 04 July 2017

Abstract

BackgroundThe sexual and reproductive health SRH status of female sex workers is influenced by a wide range of demographic, behavioural and structural factors. These factors vary considerably across and even within settings. Adopting an overly standardised approach to sex worker programmes may compromise its impact on some sub-groups in local areas.

MethodsRecords of female sex workers attending clinic-, community-, or hotel-based health services in Johannesburg n = 1422 women and Pretoria n = 408 women, South Africa were analysed. We describe the population’s characteristics and identified factors associated with sexual and reproductive health outcomes, namely HIV status; previous symptomatic sexually transmitted infection STI; modern contraceptive use and number of child dependents.

ResultsThe women in Johannesburg were less likely than those in Pretoria to have HIV 42.2% vs 52.9%, or previous symptomatic STIs 44.3% vs. 8.3%, and were 1.4 fold less likely to have child dependents 20.1% vs. 15.3%. About 43% of women in Johannesburg were Zimbabwean and 40% in Pretoria. Of concern, only about 15% of women in both sites were using modern contraceptives. Johannesburg women were also more likely to access health services at a hotel 85.0% vs. 80.6% or clinic 5.7% vs. 0.5%, to have completed secondary education 57.1% vs. 36.0%, and moved house more than twice during the past year 19.6 vs. 2.0%. In both cities, risk of HIV rose rapidly with age 23.8%–58.2% vs. 22.0%–64.8%. Of interest, HIV prevalence was considerably higher in those with consistent condom use with one’s main partner than inconsistent users.

ConclusionsSex worker populations are heterogeneous. Local health programmes must prioritise services that reflect the variety and complexity of sex worker needs and behaviours, and should be designed in consultation with sex workers. Segmenting sex worker populations according to age, country of origin and place of service delivery, and training healthcare providers accordingly, could help prevent new HIV infections, improve adherence to antiretroviral treatment and increase uptake of SRH services.

KeywordsFemale sex workers HIV South Africa Prevention Sexually transmitted infections Sexual and reproductive health AbbreviationsPrEPPre-Exposure Prophylaxis

SASouth Africa

SRHSexual and Reproductive Health

STISexually Transmitted Infections

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Autor: Mariette Slabbert - Francois Venter - Cynthia Gay - Corine Roelofsen - Samanta Lalla-Edward - Helen Rees

Fuente: https://link.springer.com/







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