Abstract
BackgroundLinkages between HIV and reproductive health (RH) among female entertainment workers (EWs) have not been addressed well in most developing countries. In Cambodia, there has been considerable research on HIV epidemiology among EWs. However, there have been limited studies on RH and specifically factors related to abortion. We examine socio-behavioral characteristics, and RH practices as determinants of abortion among Cambodian EWs.MethodsA survey was conducted in Siem Reap and Battambang and Phnom Penh provinces/city among EWs in September 2012. Trained female interviewers administered the survey to 595 EWs. Two-stage cluster sampling was used to select EWs. Bivariate associations were examined using chi-squares; univariate and multivariate logistic regression were used to assess factors independently associated with reporting having at least one abortion while working as an EW.ResultsThree-quarters (75 %) of EWs were sexually active, of which nearly one third reported at least one abortion while working as an EW. About 40 % of EWs reported recent an abortion in the past six months. Contraceptive use in the past year was low. Factors found to be independently associated with reporting a recent abortion included: ages 25–29 (OR = 2.2, 95 % CI: 1.2–4.0), living with spouse/cohabitated partner (OR = 2.2, 95 % CI: 1.1–4.2), longer duration of entertainment work (OR = 4.8, 95 % CI: 2.5–9.2), higher number of partners (OR = 4.4, 95 % CI: 2.2–8.7) and being a karaoke worker (OR = 2.2, 95 % CI: 1.1–4.4).ConclusionThis study highlights a high proportion of EWs reporting abortion. While HIV vulnerability of EWs has been clearly established, broader RH needs have gone largely unrecognized and not prioritized. Though HIV/RH integrated initiatives have been introduced by the HIV program, challenges for EWs with multiple risks from professional and partners are profound. Therefore, there is an urgent need for practical programmatic approaches to help address their RH needs.
Highlights
Abortion is a major public health concern in many parts of the world, in developing countries where access to safe services is limited [1]
Study setting In September 2012, a survey was conducted in Siem Reap, Battambang provinces and the capital city Phnom Penh, Cambodia among 595 entertainment workers (EWs) as part of the mid-term review of Sustainable Action against HIV/AIDS in the Community (SAHACOM) project conducted by KHANA
Most EWs reported currently living with parents and relatives (43 %), followed by those living with friends in rented rooms or alone (32.5 %), with spouse or sexual partner (24 %)
Summary
Abortion is a major public health concern in many parts of the world, in developing countries where access to safe services is limited [1]. Each year, an estimated 42 million abortions, both safe and unsafe, are performed [2]. Abortion is legal in Cambodia before 12 weeks of pregnancy, there is a lack of trust in those available through the public health system because services are limited and facilities understaffed with compromised quality of care [7]. Linkages between HIV and reproductive health (RH) among female entertainment workers (EWs) have not been addressed well in most developing countries. In Cambodia, there has been considerable research on HIV epidemiology among EWs. there have been limited studies on RH and factors related to abortion. We examine socio-behavioral characteristics, and RH practices as determinants of abortion among Cambodian EWs
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