Contraceptive needs of female sex workers in Kenya – A cross-sectional study

Abstract

Background and objectives Female sex workers (FSWs) are thought to be at heightened risk for unintended pregnancy, although sexual and reproductive health interventions reaching these populations are typically focused on the increased risk of sexually transmitted infections. The objective of this study of FSWs in Kenya is to document patterns of contraceptive use and unmet need for contraception.

Methods This research surveys a large sample of female sex workers (N = 597) and also uses qualitative data from focus group discussions.

Results The reported level of modern contraceptives in our setting was very high. However, like in other studies, we found a great reliance on male condoms, coupled with inconsistent use at last sex, which resulted in a higher potential for unmet need for contraception than the elevated levels of modern contraceptives might suggest. Dual method use was also frequently encountered in this population and the benefits of this practice were clearly outlined by focus group participants.

Conclusion These findings suggest that the promotion of dual methods among this population could help meet the broader reproductive health needs of FSWs. Furthermore, this research underscores the necessity of considering consistency of condom use when estimating the unmet or undermet contraceptive needs of this population.

Keywords:

• Contraception
• Prostitution
• Female
• Reproductive history
• Kenya

Acknowledgements

This work was completed with support from the United States Agency for International Development (USAID) to Family Health International (FHI) under cooperative agreement #GPO-A-00-05-00022-00 and while the first (and corresponding) author was affiliated with FHI. The views expressed in this paper, however, are solely those of the named authors. We gratefully acknowledge the assistance of our colleagues who were instrumental to the fielding of this study, including Mackenzie Green, Jennifer Liku, Dominick Shattuck, Katie Tweedy, and Saade Abdallah, as well as our team of research assistants. We also greatly appreciate the technical review provided by Theresa Hatzell Hoke.

Declaration of interest:

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.