Abstract
BackgroundThe aim is to investigate the factors that might be associated with the presence of induced abortion (IA) in women prostitutes in Asturias (Spain).Methodology/Principal FindingsCross-sectional descriptive study by self-completion questionnaire of 212 women prostitutes who attended the three Sexually Transmitted Disease Clinics in Asturias, between January–December 2003. The questionnaire was designed to investigate the women's perceived knowledge (what they claimed to know), their real knowledge (what they really knew), the use of contraceptive methods and socio-demographic variables. Multivariate analysis was carried out. 92% of the participants were immigrants. 76% were practising at brothel. 37.6% (95%CI:30.7–44.4%) reported to have undergone at least one IA during their life. According to the logistic regression the “presence of IA” was directly associated with the variables “number of pregnancies”(OR:65.82;95%IC:7.73–560.14) and “years of practising prostitution”(OR:1.13;95%CI:0.99–1.29); and inversely associated with “children”(0 = no children;1 = one or more children; OR:0.005;95%CI:0.000–0.057), “women's age”(OR:0.89;95%CI:0.82–0.97) and “real contraceptive knowledge”(OR:0.50; 95%CI:0.34–0.75). Married women were more likely to have undergone an IA (OR:2.74;95%IC:1.05–7.13). No association with “perceived contraceptive knowledge” was found.Conclusions/SignificanceThe characteristics more closely linked to the reproductive history of the women (such as “pregnancies”, “children”), together with the “real contraceptive knowledge” and the “time practising prostitution” explain the presence of IA better than factors more closely linked to the conditions in which the women practise prostitution (“place of activity”, “other activities compatible with prostitution”, “use of safe method in commercial relation”). It is possible that IA is being used as a birth control method, hypothesis suggested by the inverse association observed between the variable “children” and the “presence of IA”. Therefore, the promotion of the use of safe contraceptive methods should be a high-priority. If the real contraceptive knowledge was measured correctly, all strategies to increase it would be justified because it was inversely associated with the presence of IA.
Highlights
The rates of induced abortion (IA) in Asturias in women between 15 and 44 years were the highest in Spain between 1991 and 1996 [1,2], and the situation has improved in recent years, Asturias still ranked fourth among the Spanish Autonomous Regions in 2000 [2]
The public health studies have focussed on the incidence and prevalence of HIV and on other SexuallyTransmitted Diseases (STD), due to their association with HIV, and on the use of condoms to prevent STD transmission [17,18], since classically these women have been considered to constitute a high risk for the transmission of HIV and STD among the general population through their clients [19]
The study population was composed of women practising prostitution who had come to the STD centres of the Asturian Health Service (Monte Naranco Hospital or Pumarın Health Centre) and to the STD clinic of the PRIAPA Project for women prostitutes of Doctors of the World Asturias during the course of 2003 (N = 911)
Summary
The rates of induced abortion (IA) in Asturias in women between 15 and 44 years were the highest in Spain between 1991 and 1996 [1,2], and the situation has improved in recent years, Asturias still ranked fourth among the Spanish Autonomous Regions in 2000 [2] This explains why the reduction of the number of unwanted pregnancies and IAs was one of the objectives detailed in the Health Strategies for Asturias [1,3,4] and in the last Health Plan covering the period 2004 to 2007 [4]. It is very important to know and understand the factors associated with the presence of IAs in women prostitutes in order to plan any strategy, such as educational and contraceptive programs, aimed at reducing the incidence of IAs in this group of women. The aim is to investigate the factors that might be associated with the presence of induced abortion (IA) in women prostitutes in Asturias (Spain)
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