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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Unmet need for contraception among sex workers in Madagascar
Contraception, Volume 79, No. 3, Year 2009
Notification
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Description
Background: The study was conducted to investigate past and future pregnancy preferences and contraceptive need among Malagasy sex workers. Study Design: We analyzed data on pregnancy and contraceptive use collected during the baseline visit of a randomized, prospective formative trial which assessed diaphragm and microbicide acceptability among sex workers. To be eligible, women could not be pregnant or planning pregnancy for the next 2 months. Results: Women (N=192) from four cities (Antananarivo, Antsiranana, Mahajanga and Toamasina) reported a median of 10 sex acts per week. Fifty-two percent reported a prior unwanted pregnancy, 45% at least one induced abortion and 86% that preventing future pregnancy was moderately to very important. During the last sex act, 24% used a hormonal method, 36% used a male condom, 2% used a traditional method and 38% used no method. Nearly 30% of participants reported that pregnancy prevention was moderately or very important but used no contraception at last sex; these women were categorized as having "unmet need" for contraception. In multivariable binomial regression analyses, factors associated with unmet need included low knowledge of contraceptive effectiveness [age- and site-adjusted prevalence ratio (PR): 2.1; 95% confidence interval (CI): 1.4-3.0] and low self-efficacy to negotiate condom use (age- and site-adjusted PR: 2.0; 95% CI: 1.4-3.0). Conclusions: Among these women, prior unwanted pregnancy and induced abortion were common and preventing future pregnancy was important, yet gaps in contraceptive use were substantial. Contraceptive knowledge and self-efficacy should be improved to promote contraceptive use by sex workers. © 2009 Elsevier Inc. All rights reserved.
Authors & Co-Authors
Khan, Maria Rabia
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Turner, Abigail Norris
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Pettifor, Audrey E.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
van Damme, Kathleen
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Madagascar, Antananarivo
University of North Carolina
Rabenja, Ny Lovaniaina
Madagascar, Antananarivo
University of North Carolina
Ravelomanana, Noro Lantoniaina Rosa
Madagascar, Antananarivo
University of North Carolina
Swezey, Teresa A.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Williams, D'Nyce
United States, Atlanta
Centers for Disease Control and Prevention
Jamieson, Denise J.
United States, Atlanta
Centers for Disease Control and Prevention
Behets, Frieda M.T.F.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Statistics
Citations: 55
Authors: 10
Affiliations: 3
Identifiers
Doi:
10.1016/j.contraception.2008.09.011
ISSN:
00107824
Research Areas
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Exploratory Study
Study Locations
Madagascar
Participants Gender
Male
Female