Frances H Ampt 1 2, Megan S C Lim 1 2 3, Paul A Agius 1 2 4, Matthew F Chersich 5 6, Griffins Manguro 7, Caroline M Gichuki 7, Mark Stoové 1, Marleen Temmerman 7 6 8, Walter Jaoko 9, Margaret Hellard 1, Peter Gichangi 7 9, Stanley Luchters 1 2 6 8
Affiliations
- 1Burnet Institute, Melbourne, SA, Australia.
- 2School of Public Health and Preventive Medicine, Monash University, Melbourne, SA, Australia.
- 3Melbourne School of Global and Population Health, University of Melbourne, Melbourne, SA, Australia.
- 4Judith Lumley Centre, La Trobe University, Melbourne, SA, Australia.
- 5Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.
- 6International Centre for Reproductive Health, Department of Primary Care and Public Health, Ghent University, Ghent, Belgium.
- 7International Centre for Reproductive Health, Mombasa, Kenya.
- 8Aga Khan University, Nairobi, Kenya.
- 9University of Nairobi, Nairobi, Kenya.
PMID: 31090059
DOI: 10.1002/ijgo.12862
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.
Keywords: Cluster-randomized design; Complex sampling; Contraceptive implant; Intra-uterine device; Kenya; Long-acting reversible contraception; Sex work.
© 2019 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
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