Factors associated with induced abortion among female entertainment workers: a cross-sectional study in Cambodia

Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Khimuy Tith, Carinne Brody, Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Khimuy Tith, Carinne Brody

Abstract

Objective: To explore risk factors associated with induced abortion among sexually active female entertainment workers (FEWs) in Cambodia.

Design: Cross-sectional study.

Setting: Phnom Penh and Siem Reap, Cambodia.

Participants: This study included 556 FEWs aged 18-47 years randomly selected from entertainment establishments in the two cities in 2014 using a two-stage cluster sampling method. Data were collected through face-to-face interviews using a structured questionnaire.

Primary outcome measure: History of induced abortion during the time working as a FEW.

Results: Of the total sample, 45.6% reported currently using a contraceptive method with condom (42.4%) being the most common method, followed by pills (25.6%). One-fourth (25%) of the respondents reported having been pregnant at least once, and 21.4% reported having at least one induced abortion during the time working as a FEW. After controlling for other covariates in a multivariate logistic regression model, FEWs with a history of induced abortion remained significantly more likely to be currently working in a karaoke bar (AOR=1.75, 95% CI 1.10 to 2.78), to have worked longer as a FEW (AOR=1.42, 95% CI 1.06 to 1.43), to have had a greater number of sexual partners in the past 12 months (AOR=1.86, 95% CI 1.02 to 1.54), to be currently using a contraceptive method (AOR=1.52, 95% CI 1.01 to 2.29), to be able to find condoms when they needed them (AOR=2.03, 95% CI 1.09 to 3.82), and to report inconsistent condom use with non-commercial partners in the past 3 months (AOR=1.62, 95% CI 1.06 to 3.44).

Conclusions: This study highlights the high rates of unwanted pregnancies that ended in induced abortions among FEWs in Cambodia. Access of FEWs to quality sexual and reproductive healthcare services is deemed a high priority. Integrated interventions to improve sexual and reproductive health among these vulnerable women should be tailored to reach the most-at-risk groups.

Keywords: EPIDEMIOLOGY; PREVENTIVE MEDICINE; PUBLIC HEALTH; REPRODUCTIVE MEDICINE.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

References

    1. Webber G, Edwardsb N, Grahamet ID et al. . Life in the big city: the multiple vulnerabilities of migrant Cambodian garment factory workers to HIV. Womens Stud Int Forum 2010;33:159–69. 10.1016/j.wsif.2009.12.008
    1. Union Aid Abroad–Australian People for Health, Education and Development Abroad (APHEDA). Cambodia—addressing HIV vulnerabilities of indirect sex workers during the financial crisis: situation analysis, strategies and entry points for HIV/AIDS workplace education. Bangkok, Thailand, 2011.
    1. National Center for HIV/AIDS, Dermatology, and STDs (NCHADS). Annual report 2012. Phnom Penh, Cambodia: NCHADS, 2013.
    1. Yi S, Chhoun P, Brant S et al. . The Sustainable Action against HIV and AIDS in Communities (SAHACOM): end-of-project evaluation. Phnom Penh, Cambodia: KHANA, 2014.
    1. Couture MC, Sansothy N, Sapphon V et al. . Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine-type stimulant use: new challenges to HIV prevention and risk. Sex Transm Dis 2011;38:33–9. 10.1097/OLQ.0b013e3182000e47
    1. Bui TC, Markham CM, Tran LT et al. . Condom negotiation and use among female sex workers in Phnom Penh, Cambodia. AIDS Behav 2013;17:612–22. 10.1007/s10461-012-0369-9
    1. Maher L, Mooney-Somers J, Phlong P et al. . Condom negotiation across different relationship types by young women engaged in sex work in Phnom Penh, Cambodia. Glob Public Health 2013;8:270–83. 10.1080/17441692.2013.767930
    1. Couture MC, Page K, Stein ES et al. . Cervical human papillomavirus infection among young women engaged in sex work in Phnom Penh, Cambodia: prevalence, genotypes, risk factors and association with HIV infection. BMC Infect Dis 2012;12:166 10.1186/1471-2334-12-166
    1. Ministry of Education, Youth, and Sport (MEYS). Examining life experiences and HIV risks of young entertainment workers in four Cambodian cities. Phnom Penh, Cambodia: MEYS, 2010.
    1. Morineau G, Neilsen G, Heng S et al. . Falling through the cracks: contraceptive needs of female sex workers in Cambodia and Laos. Contraception 2011;84:194–8. 10.1016/j.contraception.2010.11.003
    1. Tsakiridu DO, Franco Vidal A, Vázquez Valdés F et al. . Factors associated with induced abortion in women prostitutes in Asturias (Spain). PLoS ONE 2008;3:e2358 10.1371/journal.pone.0002358
    1. Lau JT, Mui LW, Tsui HY et al. . Prevalence of induced abortion and associated factors among Chinese female sex workers in Hong Kong. J Sex Marital Ther 2007;33:19–29. 10.1080/00926230600998441
    1. Regushevskaya E, Dubikaytis T, Laanpere M et al. . Risk factors for induced abortions in St Petersburg, Estonia and Finland. Results from surveys among women of reproductive age. Eur J Contracept Reprod Health Care 2009;14:176–86. 10.1080/13625180902916038
    1. David PH, Reichenbach L, Savelieva I et al. . Women's reproductive health needs in Russia: what can we learn from an intervention to improve post-abortion care? Health Policy Plan 2007;22:83–94. 10.1093/heapol/czm003
    1. Yi S, Tuot S, Chhoun P et al. . The impact of a community-based HIV and sexual reproductive health program on sexual and healthcare-seeking behaviors of female entertainment workers in Cambodia. BMC Infect Dis 2015;15:221 10.1186/s12879-015-0954-4
    1. National Center for HIV/AIDS, Dermatology, and STDs (NCHADS). Updated data on entertainment workers in Cambodia 2009. Phnom Penh, Cambodia: NCHADS; 2010.
    1. Heng S, Morineau G, Neal J et al. . 2005 Cambodia STI Prevalence Study: integrated biological and behavioral survey. Phnom Penh, Cambodia: National Center for HIV/AIDS, STDs, and Dermatology (NCHADS), 2008.
    1. Heng S, Chhea C, Tuot S. The baseline survey on HIV/AIDS knowledge, attitudes, practices and related risk behaviors among MARP. Phnom Penh, Cambodia: KHANA, 2010.
    1. National Institute of Public Health, National Institute of Statistics and ORC Macro. Cambodia demographic and health survey 2010. Phnom Penh, Cambodia: and Calverton, Maryland, USA: National Institute of Public Health, National Institute of Statistics, and ORC Macro, 2010.
    1. Ministry of Education, Youth, and Sports (MEYS). Most at risk young people survey in Cambodia 2010. Phnom Penh, Cambodia: MEYS, 2010.
    1. Ministry of Education, Youth, and Sports (MEYS). Examining life experiences and HIV risks of young entertainment workers in four Cambodian cities. Phnom Penh, Cambodia: MEYS, 2012.
    1. Yi S, Poudel KC, Yasuoka J et al. . Influencing factors for seeking HIV voluntary counseling and testing among tuberculosis patients in Cambodia. AIDS Care 2009;21:529–34. 10.1080/09540120802270268
    1. Yi S, Poudel KC, Yasuoka J et al. . Role of risk and protective factors in risky sexual behavior among high school students in Cambodia. BMC Public Health 2010;10:477 10.1186/1471-2458-10-477
    1. Yi S, Poudel KC, Yasuoka J et al. . Risk vs. protective factors for substance use among adolescents in Cambodia. J Subst Use 2011;16:14–26. 10.3109/14659890903531261
    1. Abdala N, Zhan W, Shaboltas AV et al. . Correlates of abortions and condom use among high risk women attending an STD clinic in St. Petersburg, Russia. Reprod Health 2011;8:28 10.1186/1742-4755-8-28
    1. Cleeve A, Phrasisombath K, Sychareun V et al. . Attitudes and experiences regarding induced abortion among female sex workers, Savannakhet Province, Laos. Sex Reprod Healthc 2014;5:137–41. 10.1016/j.srhc.2014.03.001
    1. Center for Disease Control and Prevention (CDC). Clinical prevention guidance: sexually transmitted diseases, treatment guidelines 2010. Atlanta, GA, USA: CDC, 2011.
    1. Weldegebreal R, Melaku YA, Alemayehu M et al. . Unintended pregnancy among female sex workers in Mekelle city, northern Ethiopia: a cross-sectional study. BMC Public Health 2015;15:40 10.1186/s12889-015-1366-5
    1. Mun P. Comparison of HIV risk behaviors between karaoke workers and beer promotion girls in 2003 (in Khmer). Phnom Penh: International University Press, 2005.
    1. Decker MR, Yam EA, Wirtz AL et al. . Induced abortion, contraceptive use, and dual protection among female sex workers in Moscow, Russia. Int J Gynaecol Obstet 2013;120:27–31. 10.1016/j.ijgo.2012.07.026

Source: PubMed

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