Dual contraceptive use and associated factors among female sex workers in Gulu City, Uganda in 2023

Felix Bongomin; Pebalo Francis Pebolo; Winnie Kibone; Pamela Okwir Apio; Lauryn Nsenga; Jerom Okot; Grace Madraa; Fiona Gladys Laker; Martha Akello; Simple Ouma; David Musoke

doi:10.1186/s41182-023-00536-6

Dual contraceptive use and associated factors among female sex workers in Gulu City, Uganda in 2023

Trop Med Health. 2023 Aug 16;51(1):45. doi: 10.1186/s41182-023-00536-6.

Authors

Affiliations

¹ Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda. drbongomin@gmail.com.
² Department of Reproductive Health, Faculty of Medicine, Gulu University, Gulu, Uganda.
³ School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
⁴ Makerere Lung Institute, School of Medicine, Makerere University, Kampala, Uganda.
⁵ School of Medicine, Kabale University, Kabale, Uganda.
⁶ Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda.
⁷ Department of Rural Development and Agri-Business, Faculty of Agriculture, Gulu University, Gulu, Uganda.
⁸ Urban Research and Consultancy East Africa Limited, Kampala, Uganda.
⁹ Voice of Community Empowerment, Gulu, Uganda.
¹⁰ The AIDS Support Organization, Kampala, Uganda.
¹¹ The Institute of Clinical Trials and Methodology, University College London, London, UK.
¹² Department of Pharmacology and Therapeutics, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda.

Abstract

Background: Dual contraception is an essential approach to mitigating the heightened risks of unintended pregnancies and sexually transmitted infections faced by female sex workers (FSWs). We determined the prevalence and factors associated with dual contraceptive use among FSWs in Northern Uganda.

Methods: A cross-sectional study was conducted in Gulu city, Uganda between February, and March 2023. Purposively selected FSWs aged 18 years or older who provided verbal informed consent were enrolled in the study. A sample size of 374 was estimated. Data on sociodemographic and reproductive health characteristics were collected using an interviewer-administered semi-structured questionnaire. Current dual contraception was defined the as concurrent use of a barrier and any other modern contraceptive methods within the last 3 months. Continuous variables were summarized using mean and standard deviation and categorical variables were summarized using frequencies and percentages. Modified Poisson regression analysis was used to determine factors associated with dual contraceptive use.

Results: We enrolled 314 FSWs, with a mean age of 28.8 ± 6.4 years. About 13.8% (n = 41) were living with HIV. In total, 66.2% (95%CI 60.8-71.3) of the participants (n = 208) reported current dual contraceptive use. The most common modern contraceptive method used was the implants (52.4%, n = 109), followed by injectable contraceptives (22.6.0%, n = 47), and bilateral tubal ligation (0.5%, n = 1) was the least utilized. Having had at least one previous pregnancy was positively associated with dual contraceptive use (adjusted PR: 1.87, 95%CI 1.40-2.51, p < 0.001).

Conclusions: A high proportion of FSWs in Gulu city were currently using dual contraceptives. Interventions are needed to facilitate the use of dual contraception, particularly among FSWs without a history of previous pregnancies.

Keywords: Condoms; Dual contraceptive; Female sex workers; Implants.