Socioeconomic, behavioural and sexual-health factors associated with nutritional status of female commercial sex workers in Dhaka city, Bangladesh: a cross-sectional study

Abstract

Abstract Objectives: To investigate the prevalence of nutitional status of female commercial sex workers (FCSWs) in Dhaka city and to determine which socio-economic, behavioural and sexual health practices associated with chronic energy deficiency (CED) and overweight/obesity. Methods: Cross-sectional study conducted among 635 FCSWs (308 hotel-based/HBSWs and 327 floating-based/FBSWs). Research tools were pretested questionnaire and anthropometric measurement (height–weight). Multistage sampling technique was employed to collect the data according to probability proportional to size from 7 hotels and 3 spots. Socio-demographic, sexual-health and behavioural data were collected by direct interview of the FCSWs from working places and were processed by statistical software package. Multinomial logistic regression model was used to determine the factors influencing BMI kg/m2 of FCSWs. Results: Mean age of the FCSWs was 21.1 years with a range of 14 to 55 years. Vast majority of FCSWs were illiterate (65.8%), widowed/separated/abandoned (44.6%) followed by 43.5% married. Prevalence of CED (<18.5 kg/m2) and overweight/obesity (≥25) was 22.8% and 16.3%, respectively. CED rate was almost doubled among FBSWs than HBSWs (P < .001). From the fitted MNLR model, variables like being HBSWs [odds ratio (OR) = .518], no mass media exposure (OR = 2.29) are found to be significant (P < .05) in the model of normal BMI verses CED. Similarly, being HBSWs (OR = 2.2), <26 years age (OR = .418), one-time coital frequency with normal clients (OR = .412), 1 to 7 days monthly absent (OR = .381), no alcohol consumption (OR = .149), drug habit (cannabis) (OR = .441), monthly income ≤7000 BDT (OR = .487) are found to be significant in the model of normal BMI verses overweight/obesity. Conclusion: FCSWs face double burden of malnutrition. Older age, higher income, being hotel-based FCSW, frequency of coitus, monthly abstinence from sex work, regular alcohol consumption and taking no drug are influential factors for overweight/obesity while being floating FCSW and having no mass media items (TV/Radio) are important determinants of CED.