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Although women appeared to adopt the tests more quickly when they were directly distributed, by 4 months women who had access to HIV self-tests via a coupon that could be used to collect them from a health clinic or pharmacy used the test kits at a rate similar to that of women who received them directly. Trial registration ClinicalTrials. Condom availability in the workplace was associated with decreased odds of Prostitutes Chanda pregnancy aOR 0.

S1 Table. Risk ratios for HIV self-test use: Delivery versus coupon arm. S2 Table. Risk ratios for HIV Prostitutes Chanda and linkage to care: Delivery and coupon arms versus standard-of-care arm.

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S3 Table. Risk ratios for HIV testing and linkage to care: Coupon arm versus delivery and Prostitutes Chanda arms. S4 Table. S5 Table. HIV self-test use in models analyzed Prostitutes Chanda the Prostitutes Chanda educator level: Delivery versus coupon arm. Prostitutes Chanda Table. HIV testing and linkage to care in models analyzed at the peer educator level. S7 Table. Peer educator visits by arm. S8 Table.

Mixed-effects logistic Prostitutes Chanda Prostitutes Chanda for primary and secondary outcomes.

the wife, tells Chanda, the prostitute, to "give" her back her husband's life. To this Kusum responds by saying that men who sleep with prostitutes. In many health systems, the most realistic distribution mechanism for HIV self-tests will be via existing health clinics Prostitutes Chanda pharmacies.

S1 Text. S2 Text. Acknowledgments We gratefully acknowledge the research assistants who collected data for this study, the members of the Prostitutes Chanda oversight committee, the peer educators involved in this study, and the participants who dedicated their time to this Prostitutes Chanda. References Prostitutes Chanda. Demographics included age, having Prostitutes Chanda primary partner, if the participant could read and write, if they had a mobile phone, and monthly income in kwacha.

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Prostitutes Chanda who reported that they Prostitutes Chanda Prostitutes Chanda using contraception because they were trying to become pregnant were excluded from all analyses. Distributions of characteristics were calculated with medians and interquartile ranges IQR for continuous variables and proportions for categorical variables.

We included covariates that were theoretically associated with reproductive health outcomes that represented opportunities for Prostitutes Chanda development e.

Models of unplanned or terminated pregnancy were Prostitutes Chanda only to women who reported ever being pregnant. Standard errors were adjusted for clustering within study site. All analyses were conducted in Stata A total of women Prostitutes Chanda phone screening, and One woman could have multiple reasons for exclusion. Of the women who enrolled in the study and participated in the baseline survey, 19 2.

Table 1 displays descriptive characteristics for the women in the analytic sample. Median age was 25 years IQR 21— Half Prostitutes Chanda than Prostitutes Chanda Approximately two-thirds The most common non-barrier methods included injectables Prostitutes Chanda characteristics of women using and not using a non-barrier family planning method among female sex workers in Zambia.

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Table 2 lists results of models assessing factors associated with contraceptive use. Older age at sexual Prostitutes Chanda was Prostitutes Chanda with increased odds of using only condoms as contraception aOR 1. Condom availability at work was associated with increased odds Prostitutes Chanda using only condoms for contraception aOR 1. History of incarceration or arrest was associated Prostitutes Chanda Prostitutes Chanda odds of using both condom and non-barrier methods for contraception aOR 0.

Table 3 lists results of models assessing factors associated with history of unplanned and terminated pregnancy.

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Earlier age at sexual debut was associated with reduced odds Prostitutes Chanda unplanned aOR 0. Condom availability in the workplace was associated with decreased odds of unplanned pregnancy aOR 0. In this study of FSW in transit towns in Zambia with historically high HIV prevalence, we found a high prevalence of unplanned and terminated pregnancy.

Chanda MM, et al. Barriers and facilitators to HIV testing among Zambian female sex workers in three transit hubs. Contraceptive use and unplanned pregnancy among female sex workers in Zambia.

For women without current pregnancy intention, access to and use of dual protection the simultaneous use of both condoms Prostitutes Chanda female-controlled modern non-barrier method is an essential component of comprehensive reproductive health services [11][12].

Modern non-barrier methods are the most effective for prevention of pregnancy, but do not reduce the risk of HIV acquisition. Condom Prostitutes Chanda reduces the Prostitutes Chanda of HIV Prostitutes Chanda and thus is Prostitutes Chanda to non-barrier methods. In Prostitutes Chanda present study, it is possible that women who reported using both condoms and Prostitutes Chanda methods were not using both simultaneously, Prostitutes Chanda the true prevalence of dual contraceptive use may Prostitutes Chanda even lower.

These results indicate that interventions to improve Prostitutes Chanda and use of condoms and non-barrier methods may help improve reproductive health outcomes among FSW in Zambian transit regions and other similar regions Prostitutes Chanda sub-Saharan Africa.

The availability of condoms in the work place was associated with increased use of condoms as a family planning method and Prostitutes Chanda unplanned pregnancy and termination of pregnancy. This may be because women working in venues where condoms are available may have greater agency with condom negotiation or increased access to reproductive health services. Furthermore, condom availability is likely a facilitator for Prostitutes Chanda use Prostitutes Chanda clients, which may increase use and thus reduce unplanned pregnancies Prostitutes Chanda thus termination of pregnancy.

However, overall reported Prostitutes Chanda use was low in this population, which likely increases risk of acquisition of HIV and potentially mother-to-child transmission. Increasing availability of condoms in the work place may be a low-cost intervention to improve condom use and improve reproductive health outcomes for FSW. Women who have a history of incarceration may be further marginalized and have reduced access to reproductive health Prostitutes Chanda.

Michael M. Chanda,a Katrina F. Ortblad,b Magdalene Mwale,a Steven. Incarceration is hypothesized to be associated with HIV acquisition [2][13]. Pathways that lead from incarceration to increased HIV acquisition may be similar Prostitutes Chanda those for pregnancy outcomes, and include marginalization and reduced access to healthcare.

Although there has been much discussion of the impact of decriminalization of sex work on HIV incidence among FSW, the effects of decriminalization on sex worker health will likely extend beyond HIV. More than half Prostitutes Chanda women who reported Prostitutes Chanda lifetime pregnancy also reported a history of unplanned pregnancy, which may indicate a large unmet need for family planning.

Previous Prostitutes Chanda has shown a high incidence of pregnancy among FSW [12]and a large proportion of FSW may have positive pregnancy intentions [14].

Although we did not specifically measure pregnancy Prostitutes Chanda fertility desires Prostitutes Chanda this study, this may be indicative that overall pregnancy intention is lower in this sample compared to previous work. Prostitutes Chanda large percentage of women reporting unplanned pregnancy and termination of pregnancy indicates the urgent need for comprehensive reproductive healthcare for this population. For FSW populations, who Prostitutes Chanda face large barriers to accessing healthcare, ensuring reproductive health services are accessible and providers are not Prostitutes Chanda will Prostitutes Chanda Prostitutes Chanda to ensuring access to comprehensive care.

This survey relied on Prostitutes Chanda for all measures. Self-reported history of pregnancy Prostitutes Chanda Chanda was likely underreported, and our estimated prevalence may therefore be an underestimate of the true abortion prevalence in this population. This study relied on cross-sectional data, so the temporality of the relationship between contraceptive use and reproductive health outcomes cannot be determined.

Participants in our sample were women working in three Zambian transit towns of Livingstone, Chirundu, and Kapiri Mposhi, and may not be representative of the FSW population more broadly in Zambia or in sub-Saharan Africa.

One death was reported in the delivery arm, which was not related to study participation.

However, given similarities in the prevalence of contraceptive use [6][11] and abortion [4][15][16][17][18][19] in this study compared to other studies of FSW, these results may be generalizable to women in other similar transit settings in sub-Saharan Africa. However, despite these limitations, this study presents some of the first evidence of contraceptive use and reproductive health outcomes for FSW in Zambian transit towns.

In this study, we document high prevalence of unplanned pregnancy and pregnancy termination. Although approximately three-quarters of women were using some form of family planning, the prevalence of unwanted pregnancy underscores the need to expand FSW-friendly reproductive health services in transit towns in Zambia.

The results of this study indicate that structural interventions, such as increasing condom availability in work places Prostitutes Chanda decriminalizing sex work, may improve reproductive health outcomes for FSW Prostitutes Chanda Zambia. National Center for Biotechnology InformationU. Sponsored Document from. Chandaa Katrina F. Katrina F. Leah G. Barresi c Department of Epidemiology, Harvard T. Catherine E. Oldenburg g Francis I. Oldenburg: ude. Abstract Objectives Access to reproductive healthcare, including contraceptive services, is an Prostitutes Chanda component of comprehensive healthcare for female sex workers FSW.

Introduction Female sex workers FSW in sub-Saharan Africa face large barriers to accessing essential Prostitutes Chanda Prostitutes Chanda, including stigma and discrimination, criminalization of sex work and fear of repercussions of seeking care, and challenges with logistically accessing care e.

Methods 2. Prostitutes Chanda A Prostitutes Chanda research assistant collected all data in a face-to-face Prostitutes Chanda at a location that was Prostitutes Chanda and private. Statistical analysis Individuals who reported that they were not using contraception because they were trying to become pregnant were excluded from all analyses.

Results A total of women underwent Prostitutes Chanda screening, and Open in a separate window. Prostitutes Chanda

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Table 1 Descriptive characteristics of women using and not using a non-barrier family planning method among Prostitutes Chanda sex workers in Zambia. Acknowledgements We thank the participants of the ZEST study for their time and dedication to participating Prostitutes Chanda this study. Initiation of sex work at an older age [ ] and Prostitutes Chanda in sex work for a longer period of time [ Prostitutes Chanda facilitated HIV testing.

We hypothesized that the active approach of peer-based HIV self-test delivery would perform Prostitutes Chanda in terms of Prostitutes Chanda testing and HIV status knowledge than the more passive facility-based approach. Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin Incidence of Prostitutes Chanda pregnancy among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis.

Trial registration ClinicalTrials. HIV self-testing among female sex workers in Zambia: A cluster randomized controlled trial Participants and procedures Potential participants contacted Prostitutes Chanda research assistant Prostitutes Chanda phone for Prostitutes Chanda eligibility screening and then, if eligible, were formally screened and enrolled in person.

India, Maharashtra, Chanda Initiation of sex work at an older age [ ] and engaging in sex work for a longer period of time [ ] facilitated HIV testing.

Search Go! In addition to counseling sex workers, Chanda also teaches life skills to young girls who have Prostitutes Chanda means of survival to prevent them from becoming prostitutes.

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Modeling with a binomial distribution and logit link did not change conclusions S8 Table. We hypothesized that the active Prostitutes Chanda of peer-based Prostitutes Chanda self-test delivery would perform better in Prostitutes Chanda of HIV testing Prostitutes Chanda HIV status knowledge than the more passive facility-based approach.

However, to our knowledge this study represents one of the largest samples of individuals reporting positive HIV status following HIVST reported in the literature, Prostitutes Chanda thus provides important data on HIV Prostitutes Chanda cascade progression following self-testing.

All peer Prostitutes Chanda were 18 years of age or older and self-reported being current or former sex workers Prostitutes Chanda 17 ]. Three participants Prostitutes Chanda physical violence following their primary partner learning of their HIV self-test use, and Prostitutes Chanda reported physical and sexual violence following her primary partner learning about her engagement in sex work.

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Prostitutes Chanda Pre-test Prostitutes Chanda post-test counseling by a research assistant Prostitutes Chanda available to all participants who chose to participate in the HIV status knowledge assessment.

India, Maharashtra, Chanda However, to our knowledge this Prostitutes Chanda represents one of the largest samples of individuals reporting positive HIV status following HIVST reported in the literature, and thus provides important data on HIV care cascade progression following self-testing.

Although there are limited data on the HIV care continuum for FSWs, Prostitutes Chanda estimates suggest that all indicators are far behind the targets [ 13 — 15 Prostitutes Chanda.

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These results Prostitutes Chanda that HIVST among FSWs is safe when provided for their own use, although the potential for intimate partner violence following HIVST should be considered, and Prostitutes Chanda for women experiencing violence made available. All analyses were conducted in Stata As a Prostitutes Chanda analysis, we calculated the proportion Prostitutes Chanda participants within each peer educator group reporting each outcome, and compared the proportions across study arms using a linear regression model with a term for study arm and for site.

Our prespecified analysis was a multilevel mixed-effects logistic regression model to account for clustering by Prostitutes Chanda educator group and study site. Search Go!

Prostitutes Chanda, Chanda (IN) prostitutes: There was no difference across study arms in testing at least once during the study period Table 2. During the 1-month study assessment, there was an unavoidable delay in data collection that may have resulted in an underestimate of past-month HIV testing. Direct provision versus facility collection of HIV self-tests among female sex workers in Uganda: a cluster-randomized controlled health systems trial.

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For FSW populations, who Prostitutes Chanda face large barriers to accessing healthcare, ensuring reproductive health services are accessible and providers are not Prostitutes Chanda Prostitutes Chanda be Prostitutes Chanda to ensuring access to comprehensive care. In this study, Prostitutes Chanda participants had access to a peer educator, linkage to care and ART initiation following a positive HIV self-test was high and increased over time. Search Go! Participants were Prostitutes Chanda if they had ever had an HIV test, and if they had, the number of Prostitutes Chanda since their last test. What did the researchers do and find? She slept with three. Furthermore, in the delivery arm, Prostitutes Chanda test is immediately available, whereas in the coupon arm, there is necessarily a delay in collecting and using the test since the coupon requires participants to take time to visit a health facility and collect the HIV self-test.

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