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Ampt FH, Lim MSC, Agius PA, Chersich MF, Manguro G, Gichuki CM, Stoové M, Temmerman M, Jaoko W, Hellard M, Gichangi P, Luchters S. Use of long-acting reversible contraception in a cluster-random sample of female sex workers in Kenya. Int J Gynaecol Obstet 2019; 146:184-191. [PMID: 31090059 DOI: 10.1002/ijgo.12862] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 11/20/2018] [Accepted: 05/13/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess correlates of long-acting reversible contraceptive (LARC) use, and explore patterns of LARC use among female sex workers (FSWs) in Kenya. METHODS Baseline cross-sectional data were collected between September 2016 and May 2017 in a cluster-randomized controlled trial in Mombasa. Eligibility criteria included current sex work, age 16-34 years, not pregnant, and not planning pregnancy. Peer educators recruited FSWs from randomly selected sex-work venues. Multiple logistic regression identified correlates of LARC use. Prevalence estimates were weighted to adjust for variation in FSW numbers recruited across venues. RESULTS Among 879 participants, the prevalence of contraceptive use was 22.6% for implants and 1.6% for intra-uterine devices (IUDs). LARC use was independently associated with previous pregnancy (adjusted odds ratio for one pregnancy, 11.4; 95% confidence interval, 4.25-30.8), positive attitude to and better knowledge of family planning, younger age, and lower education. High rates of adverse effects were reported for all methods. CONCLUSION The findings suggest that implant use has increased among FSWs in Kenya. Unintended pregnancy risks remain high and IUD use is negligible. Although LARC rates are encouraging, further intervention is required to improve both uptake (particularly of IUDs) and greater access to family planning services.
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Affiliation(s)
- Frances H Ampt
- Burnet Institute, Melbourne, SA, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, SA, Australia
| | - Megan S C Lim
- Burnet Institute, Melbourne, SA, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, SA, Australia.,Melbourne School of Global and Population Health, University of Melbourne, Melbourne, SA, Australia
| | - Paul A Agius
- Burnet Institute, Melbourne, SA, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, SA, Australia.,Judith Lumley Centre, La Trobe University, Melbourne, SA, Australia
| | - Matthew F Chersich
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.,International Centre for Reproductive Health, Department of Primary Care and Public Health, Ghent University, Ghent, Belgium
| | | | | | | | - Marleen Temmerman
- International Centre for Reproductive Health, Mombasa, Kenya.,International Centre for Reproductive Health, Department of Primary Care and Public Health, Ghent University, Ghent, Belgium.,Aga Khan University, Nairobi, Kenya
| | | | | | - Peter Gichangi
- International Centre for Reproductive Health, Mombasa, Kenya.,University of Nairobi, Nairobi, Kenya
| | - Stanley Luchters
- Burnet Institute, Melbourne, SA, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, SA, Australia.,International Centre for Reproductive Health, Department of Primary Care and Public Health, Ghent University, Ghent, Belgium.,Aga Khan University, Nairobi, Kenya
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