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C : World Bank , A previous cross-sectional analysis showed that sex work-related mobility was positively associated with any recent experience of GBV as well as more severe forms of GBV [ 21 ]. These findings contrast those from Prostitutes Iringa, where mobility was not significantly associated with alcohol consumption among FSWs.

These findings support results from studies with FSWs in quite different settings 23 25 27 30 and begin to fill the gap Prostitutes Iringa in a recent systematic review by Deering et al on violence experienced by FSWs around the world. Prostitutes Iringa previous research on the potential link between work-related mobility and GBV among FSWs, we also identified an association between mobility and GBV severity.

FSWs who were highly Prostitutes Iringa for work had higher relative Prostitutes Iringa of having recently experienced more severe GBV as Prostitutes Iringa with no recent GBV than those who were not mobile. More severe forms of violence included violent threats and sexual violence, which pose significant emotional, mental and physical health risks for FSWs. These findings should be used to Prostitutes Iringa audience segmentation analyses to inform programmes working to reduce and prevent GBV as they identify those most vulnerable FSWs, such as those that are more mobile.

While some studies have argued that FSWs may be mobile or migrate in response to stigma or discrimination, 20 45 there was no Prostitutes Iringa difference in internalised sex work stigma comparing mobile and non-mobile FSWs in this sample. Internalised sex work stigma was positively associated with recent GBV as well as more severe forms of GBV, which supports findings from previous studies in sub-Saharan Africa and elsewhere emphasising how stigma and discrimination can be internalised and can negatively influence how people treat and interact with FSWs.

Alcohol consumption and number of clients may be two pathways through which work-related mobility affects exposure to GBV. A larger percentage of mobile FSWs than non-mobile FSWs reported hazardous or harmful drinking practices, and such practices were positively associated with recent GBV in adjusted models. These findings contrast those from India, where mobility was not significantly Prostitutes Iringa with alcohol consumption among FSWs.

FSWs that are more mobile may have more clients, Prostitutes Iringa may increase their risk for more severe forms of GBV. In this study, having a higher number of clients per week Prostitutes Iringa a positive relationship with recent GBV, but only comparing relative risk of more severe violence relative to no violence. Further analyses of the associations between mobility, alcohol consumption and number of clients, and their implications for GBV, are necessary. Such longitudinal research would enable an investigation of the temporal relationship between work-related mobility and Prostitutes Iringa.

As findings presented in this article were based on cross-sectional associations, we were unable to specify the temporal relationship between mobility and GBV. Mobility, for example, could have been the result, rather than a predictor, of violence. Future exploration of the context in which mobile FSWs work Prostitutes Iringa their experiences of violence, including where violence takes place and perpetrator type and more nuanced information about type of Prostitutes Iringa experienced, could strengthen our Prostitutes Iringa of the associations presented here.

As participants in a community-randomised trial, participants whose responses were analysed here are not necessarily representative of all FSWs in Tanzania. However, this is a hard to reach population where typical probability sampling approaches are challenging. Venue-based time-location sampling was used to address the challenges of recruiting a population-based sample of FSWs.

This sampling approach enables statistical methods to be used to adjust for correlations within communities where FSWs were recruited.

Mobile FSWs may have different risks as a result of their mobility 2 20 45 and therefore may have different needs for GBV services and services that facilitate preventive health behaviours, reduce risky behaviours, and encourage care-seeking. Mobility may disrupt access to services or programmes, and programmes must take this into account when developing their activities. Different stages of mobility—such as origin, Prostitutes Iringa, destination and return, may also require unique programmatic approaches.

Community empowerment responses to HIV, which enable FSWs to work within existing environments characterised by restrictive laws, stigma and discrimination, may require innovative strategies to address how to continue to engage and support mobile FSWs when they travel—either for work or for other reasons—as such mobility may impact their participation in an intervention or the effects of the intervention at the community level.

The authors would like to thank the study participants, the community and study advisory boards of Project Shikamana, MUHAS staff, peer navigators, HIV providers and all others who have assisted with Project Shikamana.

ZMH conducted analyses and Prostitutes Iringa manuscript writing. AML and NG provided input on study design and analyses and contributed to the revisions of the manuscript. JKM assisted with the study design and contributed to the revisions of the manuscript. SL assisted with the study Prostitutes Iringa and contributed to the revisions of the manuscript. DLK supervised the study, provided input on study design and analyses and contributed to the revisions of the manuscript.

Disclaimer The content presented here is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. NIH was not involved in the Prostitutes Iringa of this study, analysis or interpretation of data, manuscript writing or decision to submit for publication the results presented Prostitutes Iringa.

Provenance and peer review Not commissioned; externally peer reviewed. Data sharing statement Data set is not publicly available.

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Forgot your user name or password? Search for this keyword. Prostitutes Iringa search. Latest content Archive For authors About Browse by collection. Log in via Institution. You are here Home Archive Volume 8, Issue 9 Work-related mobility and experiences of gender-based violence Prostitutes Iringa female sex workers in Iringa, Tanzania: a cross-sectional analysis of baseline data from Project Shikamana.

Email alerts. Article Text. Article menu. Public health. Work-related mobility and experiences of gender-based violence among female sex workers in Iringa, Tanzania: a cross-sectional analysis of baseline data from Project Shikamana. Statistics from Altmetric. Data Prostitutes Iringa Descriptive statistics were used to examine distributions of all relevant indicators. Participant involvement FSWs were consulted through extensive formative research conducted prior to the baseline survey. Results Description of the sample Among participants in the survey, the mean age was 27 years SD: 6.

Prostitutes Iringa this table: View inline View popup. Table 1 Sociodemographic characteristics of FSW participants by recent experience of gender-based violence and recent work-related mobility: Iringa, Tanzania, — Table 2 Sex work-related characteristics of FSW participants by recent experience of gender-based violence and recent work-related mobility: Iringa, Tanzania, — Prostitutes Iringa 3 Unadjusted and adjusted OR of recent experience of any GBV by recent FSW work-related mobility, general mobility and relevant sociodemographic characteristics and sex work-related characteristics: Iringa, Tanzania, — Table 4 Unadjusted and adjusted RRR of recent experience of GBV Prostitutes Iringa severity by FSW work-related mobility, general mobility and relevant sociodemographic characteristics and sex work-related characteristics: Iringa, Tanzania, — References 1.

HIV infection among female sex workers in concentrated and high prevalence Prostitutes Iringa why a structural determinants framework Prostitutes Iringa needed. A systematic review of the correlates of violence against sex workers. Am J Public Health ; : e42 — Nations U. Declaration on the elimination of violence against women. Global health. The global prevalence of intimate partner violence against women. Science ; : — 8. Intimate partner violence and physical health consequences.

Arch Intern Med ; : — Prostitutes Iringa as a barrier for Prostitutes Iringa prevention among female sex workers in Argentina. PLoS One ; 8 : e Shannon KCsete J. JAMA ; : — 4. Violence victimisation, sexual risk and sexually transmitted infection symptoms among female sex workers in Thailand. Sex Transm Infect ; 86 : — Sex Transm Infect ; 88 : — Estimating the impact of reducing violence against female sex workers on HIV epidemics in Kenya and Ukraine: a policy modeling exercise.

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Am J Reprod Immunol ; 69 Suppl 1 : — Violence against female sex workers in Karnataka state, south India: impact on health, and reductions in violence following an intervention program. BMC Public Health ; 10 : Global epidemiology of HIV among female sex workers: influence of structural determinants. Lancet ; : 55 — Correlates of mental depression among female sex workers in Southern India. Asia Pac Prostitutes Iringa Public Health ; 27 : — Relationship between mobility, violence and major depression among female sex workers: a cross-sectional Prostitutes Iringa in southern India.

BMJ Open ; 6 : e Declines in violence and police arrest among female sex workers in Karnataka state, south India, following a comprehensive HIV Prostitutes Iringa programme. An action agenda for HIV Prostitutes Iringa sex workers.

Lancet ; : — Gender-based violence against female sex workers in Cameroon: prevalence and associations with sexual HIV risk and access to health services and justice. Sex Transm Infect ; 92 : — Human rights violations against sex workers: burden and effect on HIV. The global Prostitutes Iringa epidemics among sex workers. Washington, D. C : World BankProstitutes Iringa The total baseline sample included participants, with in the intervention community. Two of the participants were missing data on program exposure, so were dropped from the multivariable analysis but included in other analyses.

Further information on the recruitment Prostitutes Iringa sampling methods are described elsewhere [ 23 ]. The primary outcome was self-reported current family planning use measured at the month follow-up survey.

Participants were asked if they currently used various modern contraceptive methods including injectable, implant, oral pill combined or progesterone onlytubal ligation, or male or female condoms as birth control.

These represent a complete list of modern FP methods available in Tanzania at the time. Program exposure was measured at the month follow-up survey. Family planning program exposure was defined Prostitutes Iringa attendance of a seminar, workshop, or meeting specifically about FP. Additionally, the baseline survey captured historical FP use e. The month follow-up also asked participants about their reproductive histories numbers of lifetime pregnancies and living children; current pregnancy status; current pregnancy intentions, intendedness of most recent pregnancy; and age at first pregnancy and use of ANC services sought ANC for recent pregnancy; location of care.

Since formative qualitative work previously Prostitutes Iringa that some FSW were not accessing ANC services because they were not accompanied by husbands for couples Prostitutes Iringa testing [ 10 ], the survey also asked if participants were accompanied by a male partner, told to bring a partner, or did not or could not access services due to inability to bring a partner.

For Table 5to simultaneously evaluate the effect of various factors on the outcome, we have Prostitutes Iringa modified Poisson regression models with robust standard errors. This Prostitutes Iringa had been proposed as an alternative to logistic regression for binary data in cases where the proportion of the outcome is high, as is the case for family planning in our cohort [ 25 ]. All participants gave oral informed consent before participation. Over half of participants were single, divorced, or widowed.

Just over half of participants were living with HIV. Of those not currently pregnant, about a fifth were Prostitutes Iringa trying to become pregnant. Participants used an array of FP methods.

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Community, number Prostitutes Iringa clients a week, and history of FP use were significantly associated with current FP use Table 4. Of the participants in the intervention community, two had missing data on program exposure. The adjusted relative risk of Prostitutes Iringa FP use among FSW who reported ever attending the Shikamana center compared to those who never attended the Shikamana center was aRR 1.

This study provides an overview of the reproductive health profile of this population of FSW. Among the study population, reproductive histories and fertility preferences Prostitutes Iringa not significantly vary by HIV status, which indicates unmet service needs for both FSW who Prostitutes Iringa uninfected prevention of HIV, prevention of unwanted pregnancy and FSW who are infected safer conception, prevention of unwanted pregnancy, prevention of transmission to partners.

Community study armnumber of clients a week, and history of FP use were significantly associated with current FP use. Further, the study provides insights on the potential impact of involvement in a community empowerment HIV prevention intervention — an intervention with a very limited one seminar Prostitutes Iringa component — on FP use. The odds of current FP use among FSW was higher among those who reported ever attending the Shikamana DIC, compared those who had not, and was higher among those who reported ever attending the FP-related workshop, than those who had not.

Other qualitative research in Tanzania have also found that health providers may deny services to women and adolescents attending antenatal care without a Prostitutes Iringa [ 2728 ]. While male participation in ANC care is valuable, the lack of male accompaniment should not Prostitutes Iringa an additional barrier to receiving services.

The interpretation and implementation of such polices and guidelines at the facility level should be investigated to ensure that all pregnant people receive Prostitutes Iringa care. Many factors may Prostitutes Iringa FP use and non-use.

In this study, community of residence, average number of clients a week, and history of FP use were significantly associated with current FP use. Comprehensive interventions that meet the reproductive health needs of key populations such as FSW are Prostitutes Iringa to address unmet need for family planning [ 330 ]. Furthermore, very few participants reported dual use of both a modern contraception method and condom use.

Condom use was much higher in a recent study conducted in Kenya where a total of Little is Prostitutes Iringa about fertility preferences among FSW and other marginalized groups of women [ 333435 ]. In this study, about a fifth of participants both living with and without HIV were currently trying to get pregnant.

Prostitutes Iringa, they lacked information on safe conception practice [ 8 ]. Another study conducted in Swaziland, Burkina Faso, and Togo found that nearly a fifth of FSW reported that they were currently trying to conceive [ 18 ]. Fertility preferences may adversely impact HIV prevention and treatment efforts such as higher risk of unprotected sex [ 36 ], and treatment Prostitutes Iringa among those living with HIV [ 34 ]. Exposure to the community empowerment program — both in terms of ever attending Prostitutes Iringa Shikamana center as well as Prostitutes Iringa attended the FP-specific session — were associated with greater odds of current FP use.

This finding suggests that community empowerment models of HIV care provision may also Prostitutes Iringa impact family planning behaviors, potentially through developing sexual and RH knowledge, improving access to condoms and encouraging their use, and reducing barriers to health care seeking in general. The potential for empowerment to improve family planning outcomes has been documented in two Prostitutes Iringa literature reviews among the general population of women, though findings have been variable, with some showing an effect and others not [ 3738 ].

A review on the potential effectiveness and feasibility of integrating FP into HIV services Prostitutes Iringa that integrated programs were often associated with Prostitutes Iringa modern method of contraceptive prevalence and knowledge, though findings were mixed [ 19 ].

There are some limitations inherent in this analysis. The specific FP questions assessed here were only measured at follow-up. As such, we were unable to determine whether FP use increased from baseline to follow-up. Furthermore, Prostitutes Iringa were only able to estimate the cross-sectional association between exposure to Prostitutes Iringa empowerment program and current family Prostitutes Iringa use at follow-up. Thus, we cannot determine causality of community empowerment on family planning use; it may be that women who were Prostitutes Iringa likely to use family planning were more likely to be involved in the drop-in-center activities.

That said, we were able to control for ever use of family planning in the regression models, suggesting that FP use did come before intervention exposure. Further study with clear temporality is warranted to determine the true association.

Social determinants of health [Internet].

This study was a secondary analysis of a larger study; thus, the study was not powered on the outcome, so interpretations should be cautious. As with all self-report data, responses may be subject to social desirability bias. For example, FP Prostitutes Iringa and program exposure may have been over-reported. The time-location sampling Prostitutes Iringa may limit the generalizability Prostitutes Iringa these findings to venue-based FSW.

Future research designed to assess these outcomes could overcome some of these limitations. Community empowerment-based interventions have been shown to be effective at improving consistent condom use and reducing HIV infection. This study indicates that other health outcomes, such as modern family planning use, may also be impacted by these interventions, especially when family planning is part of a comprehensive empowerment-based program.

More attention is needed on integration of family planning into Prostitutes Iringa tailored for sex workers and other marginalized groups, including implementation research to test and develop Prostitutes Iringa practices that serve the needs of the communities. Encyclopedia of AIDS. New York: Springer; Chapter Google Scholar.

Socio-demographic characteristics and behavioral risk factors of female sex workers in sub-saharan Africa: Prostitutes Iringa systematic review. AIDS Behav. Meeting the reproductive health needs of female key populations affected by HIV in low- and middle-income countries: a review of the evidence. Stud Fam Plan. Article Google Scholar. Contraceptive use and unplanned pregnancy among female sex workers in Zambia.

Afr J Reprod Prostitutes Iringa. An urgent need for integration of family planning services into HIV care: the high burden of unplanned pregnancy, termination of pregnancy, and limited contraception use among female sex workers in cote d'Ivoire. J Acquir Immune Defic Syndr. Article PubMed Google Scholar.

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Pregnancy experiences of female sex Workers in Adama City, Ethiopia: complexity of partner relationships and pregnancy intentions. Project SOAR. Washington, DC: Population Council; Google Scholar. Female sex workers' experiences with intended pregnancy and antenatal care services in southern Tanzania.

Health of female sex workers and their children: a call for action. Lancet Glob Health. Contraceptive needs of Prostitutes Iringa sex workers in Kenya - a cross-sectional study. Contraceptive service delivery in Kenya: a qualitative study to identify barriers and preferences among female sex workers and health care providers. Are HIV and reproductive health services adapted to Prostitutes Iringa needs of female sex workers?

Results of a policy and situational analysis in Tete, Mozambique. Are services meeting the holistic family planning needs of female sex workers living with HIV in Tanzania? Book Google Scholar. Systematic review of sex work Prostitutes Iringa in sub-Saharan Africa: examining Prostitutes Iringa prevention approaches.

Family planning use and correlates among female sex workers in a community empowerment HIV prevention intervention in Iringa, Tanzania: a. See 17 traveler reviews, candid photos, and great deals for Iringa, Tanzania, they rent out the rooms to local clients to service the local prostitutes.

Tropical Med Prostitutes Iringa Health. BMJ Open. Reproductive health needs of female sex workers and opportunities for enhanced prevention of mother-to-child transmission efforts in sub-Saharan Africa.

Integration of family planning services into HIV care and treatment services: a systematic review. The impact of programs for prevention of mother-to-child transmission of HIV Prostitutes Iringa health care services and systems in sub-Saharan Africa - a Prostitutes Iringa. Public Health Rev. World Health Organization.

Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva: World Health Organization; Prostitutes Iringa empowerment among sex workers is an effective HIV prevention intervention: Prostitutes Iringa from a systematic review of the peer-reviewed evidence.

Essential elements of a community empowerment approach to HIV prevention among female sex workers engaged Prostitutes Iringa project Shikamana in Iringa, Tanzania. Culture Health Sexuality. Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. World Medical Association.

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Pessar P, Mahler S. Competing interests The authors have no competing interests to declare.

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