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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Pregnancy among sex workers participating in a condom intervention trial highlights the need for dual protection
Contraception, Volume 76, No. 2, Year 2007
Notification
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Description
Background: Little is known about pregnancy rates among sex workers (SWs) or the factors that predispose SWs to this risk. We aimed to estimate the pregnancy incidence rate among Madagascar SWs participating in an intervention trial promoting use of male and female condoms and assess the influence of various predictive factors on pregnancy risk. Methods: SWs from two study clinics in Madagascar participated in a randomized trial to assess the effect of peer education and clinic-based counseling on use of male and female condoms and prevalence of sexually transmitted infections (STIs). Women were seen every 2 months for up to 18 months; they received structured interviews at every visit, and physical exams at baseline and every 6 months thereafter. Site staff recorded information on pregnancies during interviews; pregnancy data were then merged with trial data for this analysis. Results: Of 935 SWs in the analysis population, 250 became pregnant during follow-up. The cumulative probability of pregnancy was 0.149 at 6 months and 0.227 at 12 months. Comparable proportions of nonpregnant and pregnant SWs reported using highly effective contraception at baseline (∼16%); these users were younger and were more consistent condom users. Method switching and discontinuation were frequent. In multivariate analysis, nonuse of effective contraceptives and any self-reported unprotected sex were associated with higher incidence of pregnancy. Approximately 51% of women delivered, 13% reported a spontaneous abortion, 13% reported an induced abortion and 23% had missing pregnancy outcomes. Conclusions: Women traditionally targeted for STI/HIV preventive interventions need more comprehensive reproductive health services. In particular, SWs could benefit from targeted family planning counseling and services. © 2007 Elsevier Inc. All rights reserved.
Authors & Co-Authors
Feldblum, Paul J.
United States, Durham
Fhi 360
Nasution, M.
United States, Durham
Fhi 360
Hoke, Theresa Hatzell
United States, Durham
Fhi 360
van Damme, Kathleen
Madagascar, Antananarivo
Unc-madagascar Enceinte Inspc
Turner, Abigail Norris
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Gmach, Rebecca
United States, Durham
Fhi 360
Wong, Emelita L.
United States, Durham
Fhi 360
Behets, Frieda M.T.F.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Statistics
Citations: 87
Authors: 8
Affiliations: 3
Identifiers
Doi:
10.1016/j.contraception.2007.04.009
ISSN:
00107824
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Locations
Madagascar
Participants Gender
Male
Female