Abstract
BackgroundFemale sex workers living with HIV are at increased risk for negative health outcomes and multiple levels of stigma. However, there is limited research on female sex workers living with HIV and even less focused on reproductive health.MethodsWe analyzed data using logistic regression from a cohort of 247 female sex workers of reproductive age living with HIV in Santo Domingo, Dominican Republic to assess factors associated with fertility desire.ResultsMost participants had children (93.1%; mean: 2.8; range: 1,8) and 28.3% reported fertility desire. Bivariate regression analysis uncovered that participants who desired children were less likely to report being on antiretroviral treatment and more likely to have a detectable viral load. Multivariate regression results showed participants who desired more children were: less likely to be older, have higher levels of HIV-related internalized stigma, have a history of pregnancy loss, have fewer children and have a perception that their partner has negative feelings about pregnancy.ConclusionsIndividual and interpersonal characteristics were found to be associated with fertility desire in this study. Additional in-depth research is needed to understand how the role of stigma, partner dynamics and reproductive history as it relates to fertility desire, in order to ensure the reproductive health and wellbeing of this population.
Highlights
Female sex workers living with HIV are at increased risk for negative health outcomes and multiple levels of stigma
Pregnancy, childbearing and fertility desire are common among female sex workers living with HIV in this setting
The study’s overall sample size was not calculated based on the analysis conducted for this paper potentially limiting our ability to detect significant associations. These findings emphasize the need for further research and interventions targeting stigma and partner dynamics among female sex workers living with HIV to improve their reproductive health
Summary
Female sex workers living with HIV are at increased risk for negative health outcomes and multiple levels of stigma. There is limited research on female sex workers living with HIV and even less focused on reproductive health. The global prevalence of HIV among female sex workers is estimated at 11.8% and is estimated at 13.5 times that of the general female population (women aged 15–49) in low and middle-income countries [1]. Despite this significant burden of disease there is limited research on female sex workers living with HIV, with regard to sexual and reproductive health. Many times women find themselves making childbearing decisions amidst tension between self-image, culture, social expectation and fears about health for themselves and future children [3]
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