Resumen
Background: The objective of this study was to describe levels of pregnancy and contraceptive usage among a cohort of street-based female sex workers (FSWs) in Vancouver.Methods: The study sample was obtained from a community-based prospective cohort study (2006-2008) of 211 women in street-based sex work who use drugs, 176 of whom had reported at least one prior pregnancy. Descriptive statistics were used to estimate lifetime pregnancy prevalence, pregnancy outcomes (miscarriage, abortion, adoption, child apprehension, child custody), and contraceptive usage. In secondary analyses, associations between contraceptive usage, individual and interpersonal risk factors and high number of lifetime pregnancies (defined as greater than the sample mean of 4) were examined.Results: Among our sample, 84% reported a prior pregnancy, with a mean of 4 lifetime pregnancies (median = 3; IQR: 2-5). The median age of women reporting 5+ pregnancies was 38 years old [interquartile range (IQR): 25.0-39.0] compared to 34 years [IQR: 25.0-39.0] among women reporting 4 or fewer prior pregnancies. 45% were Caucasian and 47% were of Aboriginal ancestry. We observed high rates of previous abortion (median = 1;IQR:1-3), apprehension (median = 2; IQR:1-4) and adoption (median = 1; IQR:1-2) among FSWs who reported prior pregnancy. The use of hormonal and insertive contraceptives was limited. In bivariate analysis, tubal ligation (OR = 2.49; [95%CI = 1.14-5.45]), and permanent contraceptives (e.g., tubal ligation and hysterectomy) (OR = 2.76; [95%CI = 1.36-5.59]) were both significantly associated with having five or more pregnancies.Conclusion: These findings demonstrate high levels of unwanted pregnancy in the context of low utilization of effective contraceptives and suggest a need to improve the accessibility and utilization of reproductive health services, including family planning, which are appropriately targeted and tailored for FSWs in Vancouver.
| Idioma original | English |
|---|---|
| Número de artículo | 61 |
| Publicación | BMC Pregnancy and Childbirth |
| Volumen | 11 |
| DOI | |
| Estado | Published - ago. 18 2011 |
| Publicado de forma externa | Sí |
Nota bibliográfica
Funding Information:This work was supported through an operating grant from the Canadian Institutes of Health Research (CIHR, HHP-98835). KD is supported through a CIHR and Michael Smith Foundation for Health Research (MSFHR) doctoral research trainee award, and MWT and JS are supported through a MSFHR Senior Scholar Awards. KS is supported through a MSFHR Scholar Award, a CIHR New Investigator Award, and National Institutes of Health Research (R01DA028648). JS is supported through a CIHR/PHAC Applied Public Health Chair in Improving Youth Sexual Health. We would like to extend our thanks to the women who participated project, including our many community partners, advisory board members and in particular the peer research team: Shari, Rose, Chanel, Laurie, Debbie, and Adrian. We would like to acknowledge our research and administrative staff, including Peter Vann, Ruth Zhang, Eric Fu, Ofer Amram, and Calvin Lai.
ASJC Scopus Subject Areas
- Obstetrics and Gynaecology