Induced abortion and associated factors among female sex workers in Iran

Abstract

Objectives

Induced abortion is an occupational hazard for female sex workers (FSWs). This study aimed to examine the prevalence and factors associated with induced abortion among FSWs in Iran.

Methods

1337 FSWs aged ≥18 years who reported selling sex to more than one male client in the past 12 months were recruited in 13 major cities in Iran between January and August 2015. Bivariable and multivariable modified Poisson regression models were constructed to examine the correlates of induced abortion. Adjusted prevalence ratios (APRs) with 95% confidence intervals (CIs) were reported.

Results

Lifetime induced abortion was reported by 621 of 1335 participants (46.5%; 95% CI 43.8, 49.2). Older age (APR for ≥ 35 vs. < 25 years, 1.46; 95% CI: 1.03, 2.07), having ever been married (APR 1.58; 95% CI 1.05, 2.39), having ever worked in a brothel (APR 1.19; 95% CI 1.02, 1.38) and a lifetime history of being raped (APR 1.19; 95% CI 1.03, 1.38) were significantly associated with lifetime induced abortion (all p < 0.05).

Conclusion

The high prevalence of induced abortion among FSWs in Iran is concerning. Evidence-informed programmes targeting FSWs in Iran would improve their knowledge and encourage contraceptive use as well as promote pregnancy prevention and post-abortion care.

摘要

目的：人工流产是女性性工作者的职业危害。本研究旨在调查伊朗性工作者中人工流产的发生率及其相关因素。方法：2015年1月至8月, 在伊朗13个主要城市招募了1337名18岁及以上的性工作者, 她们在过去12个月中接待过一名以上男性顾客。建立双变量和多变量修正的Poisson回归模型, 检验人工流产的相关因素。报告了调整后的发生率(APR), 其可信区间(CI)为95%。结果：1335名受试者中有621人报告有过人工流产史(46.5%；95%可信区间43.8, 49.2)。高龄(APR ≥35比<25岁, 1.46；95%CI：1.03, 2.07)、已婚(APR 1.58；95%CI 1.05, 2.39)、曾在妓院工作(APR1.19；95%CI 1.02, 1.38)和被强奸史(APR 1.19；95%CI 1.03, 1.38)与人工流产史显著相关(P均<0.05)。结论：伊朗女性性工作者人工流产率居高不下, 值得关注。针对伊朗性工作者的循证方案将提高她们的相关知识, 鼓励避孕措施的使用, 并促进妊娠预防和流产后护理。

Keywords:

• Female sex workers
• induced abortion
• Iran
• reproductive health
• survey

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The survey was funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, through the United Nations Development Programme in Iran, and by the Iranian Ministry of Health. Mohammad Karamouzian is supported by the Vanier Canada Graduate Scholarship and the Pierre Elliott Trudeau Foundation Doctoral Scholarship. Mostafa Shokoohi's research is supported by the Canadian Institute of Health Research (CIHR).