Longitudinal study of pregnancy intention and its association with pregnancy occurrence among female sex workers in Benin and Mali.

Autor: Perrault Sullivan G; Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada. gentiane80@gmail.com.; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du Chu de Québec - Université Laval, Québec, Canada. gentiane80@gmail.com.; Institut National de Santé Publique, Québec, Canada. gentiane80@gmail.com., Guédou FA; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du Chu de Québec - Université Laval, Québec, Canada.; Dispensaire IST, Centre de Santé Communal de Cotonou 1, Cotonou, Benin., Tounkara FK; Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada., Béhanzin L; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du Chu de Québec - Université Laval, Québec, Canada.; Dispensaire IST, Centre de Santé Communal de Cotonou 1, Cotonou, Benin.; École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Parakou, Benin., Camara N; ARCAD∕SIDA, Bamako, Mali., Aza-Gnandji M; Dispensaire IST, Centre de Santé Communal de Cotonou 1, Cotonou, Benin., Keita BD; ARCAD∕SIDA, Bamako, Mali., Azonnadou O; Dispensaire IST, Centre de Santé Communal de Cotonou 1, Cotonou, Benin., Thera I; ARCAD∕SIDA, Bamako, Mali., Avery L; Institute for Global Public Health, Dept. Obstetrics, Gynecology and Reproductive Sciences, Max Rady Medical College of Medicine, University of Manitoba, Winnipeg, Canada., Alary M; Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada.; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du Chu de Québec - Université Laval, Québec, Canada.; Institut National de Santé Publique, Québec, Canada.
Jazyk: angličtina
Zdroj: Reproductive health [Reprod Health] 2023 Jan 30; Vol. 20 (1), pp. 25. Date of Electronic Publication: 2023 Jan 30.
DOI: 10.1186/s12978-023-01565-4
Abstrakt: Background: The intention of becoming pregnant has an evident impact on the prenatal and postnatal period. For female sex workers (FSWs) in West Africa, among whom pregnancies are frequent as are HIV and sexually transmitted infections, a better understanding of their pregnancy intention and its influence on pregnancy occurrence could help prevent unwanted pregnancies and adverse effects on wanted pregnancies.
Methods: We recruited 330 FSWs in Benin and 322 in Mali and followed them for 12 months. We evaluated their pregnancy intention at recruitment and 6-month follow-up, using a multidimensional prospective measure that we developed. We assessed pregnancy occurrence with a pregnancy test and a retrospective questionnaire at 6 and 12 months. A Cox proportional hazard model was used to estimate the association between intention and pregnancy. We carried out an analysis to take losses to follow-up into account using the inverse of probability of censoring weights and a cluster analysis to corroborate that the multidimensional measure of pregnancy intention fitted the data.
Results: 407 FSWs were included in the first 6-month analysis and 284 at 12 months. Mean age was 30.9 years. The pregnancy intention distribution was similar between the two periods: 15.2% in the first period and 16.3% in the second had a positive intention. One out of four were ambivalent and almost 60% (57.7% and 56.3%) had a negative intention. For 38.2% of the FSWs, the intention changed between the two periods. The global incidence rate (to first event) was 19.1 pregnancies per 100 person-years. There was a borderline significant trend (p = 0.0529) of decreased pregnancy incidence with decreasing intention. Compared to positive intention, the adjusted hazard ratio (aHR) for ambivalent and negative intentions were 0.71 [95% confidence interval (95% CI) 0.32-1.60] and 0.46 (95% CI 0.21-1.01), respectively.
Conclusion: The level of pregnancy intention influences its occurrence among FSWs and nearly one out of six wants a baby despite working in the sex trade. Programmatically, early identification of these women could facilitate provision of quality antenatal and postnatal care. Given other health risks associated with sex work this care may decrease potential risks of adverse maternal, fetal and neonatal outcomes.
(© 2023. The Author(s).)
Databáze: MEDLINE
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