Browsing by Author "Barrett, Geraldine"

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    Contraceptive use, prevalence and predictors of pregnancy planning among female sex workers in Uganda: a cross sectional study
    (BMC pregnancy and childbirth, 2019) Nnakate Bukenya, Justine; Wanyenze, Rhoda K.; Barrett, Geraldine; Hall, Jennifer; Makumbi, Fredrick; Guwatudde, David
    Unintended pregnancies are associated with negative consequences to both mother and baby. Female Sex Workers (FSWs) are at high risk of unintended/unplanned pregnancies. However, prevalence of pregnancy planning and its predictors among FSWs has not been comprehensively investigated. This study was designed to determine contraceptive use, the prevalence, and predictors of pregnancy planning among FSWs in Uganda. Methods: In this cross-sectional study, 819 FSWs attending most at risk populations initiative (MARPI) clinics were recruited using systematic sampling and interviewed with a pretested questionnaire that included collection of data on pregnancy intention using the London Measure of Unplanned Pregnancy (LMUP). Data were analysed using STATA version 14.0. Multinomial logistic regression model was used to identify predictors of pregnancy planning, Results: Of the 819 study participants, only 90 (11.0%) had planned pregnancies. Overall, 462 (56.4%) were hazardous alcohol users and 335 (40.9%) abused drugs; 172 (21.0%) had been raped in the last 2 years and 70 (40.7%) of these accessed emergency contraception post-rape. Dual contraception use (condom and other modern method) was 58.0%. Having a non-emotional partner as a man who impregnated the FSW compared to emotional partner was significantly associated with less planned relative to unplanned pregnancy, (aRR = 0.15 95%Cl =0.08, 0.30), so was lack of reported social support compared to support from friends, (aRR = 0.44; 95% CI = 0.22–0.87), keeping all factors constant in the model. Being raped (aRR = 0.51; 95% CI = 0.31–0.84) or abuse of substances (aRR = 0.65; 95% CI = 0.45–0.93) were significantly associated with lower ambivalence relative to unplanned pregnancy but not with planned relative to unplanned pregnancy. Conclusion: Compared to women in the general population, pregnancy planning was low among FSWs amidst modest use of dual contraceptive. There is an urgent need to promote dual contraception among FSWs to prevent unplanned pregnancies especially with non-emotional partners, drug users, and post-rape.
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    Factors associated with utilization of maternal health services by female sex workers in Uganda: a Health facility based survey
    (Research Square, 2019) Bukenya, Justine; Barrett, Geraldine; Kaharuza, Frank; Guwatudde, David; Wanyenze, Rhoda K.
    Introduction Female sex workers (FSWs) are marginalized due to social rejection and stigma, especially in countries where the practice is illegal. Many FSWs are mothers but little is known about their utilization of maternal services. This study investigated the determinants of utilization of maternal services by FSWs in Uganda. Methods FSWs were recruited from the “Most at-Risk Initiative” clinics in Uganda. We analyzed data for 318 FSWs who had given birth within two years of the study to estimate the proportion of FSWs who used all the components of maternal services (antenatal, facility-based delivery and postnatal). The outcome variable (utilization of maternal services) was categorized as “recommended package” if the women received all the three services, “moderate” if they received any two and “limited/none” if they received only one or none of the services. Multinomial logistic regression analysis was used to quantify the impact of pregnancy planning and other factors on the utilization of maternal services. Results Overall, 25.2% (80) utilized all the three services in the recommended package of maternal services, 47.5% (151) had moderate utilization, while 27.3% (87) utilized limited or no services. Factors that influenced utilization of the recommended package compared to “limited/none” use were having a planned pregnancy (adjusted RRR (aRR) = 3.87; 95% CI = 1.40-10.67), knowing four as the minimum number of ANC visits (aRR = 2.43; 95% CI = 1.22-4.87), never having been criminalized for sex work (aRR = 2.48; 95% CI = 1.30-4.74) and not believing that health providers deny services to FSWs believing (aRR = 2.63; 95% CI = 1.37-5.07). Conclusion These findings confirm the relevance of pregnancy planning in the utilization of maternal services among FSWs. However, maternal health service utilization was generally low and interventions to reduce barriers including inadequate knowledge of ANC visits, internal stigma and criminalization of sex work are required. These are necessary steps in the move towards universal health coverage.
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    Pregnancy Planning among Female Sex Workers in Uganda: Evaluation of the Psychometric Properties of the London Measure of Unplanned Pregnancy
    (African Journal of Reproductive Health, 2019) Bukenya, Justine N.; Nalwadda, Christine K.; Neema, Stella; Kyambadde, Peter; Wanyenze, David K.; Barrett, Geraldine
    The aim of the study was to evaluate the psychometric properties of the London Measure of Unplanned Pregnancy (LMUP) among female sex workers (FSWs) in Uganda. The LMUP was translated into Luganda and adapted for use with FSWs and underwent cognitive testing and two field tests. From the final Luganda LMUP, three other language versions were created (Acholi, Lugisu and Runyakole), and preliminary field test data were collected. Final data were collected from 819 FSWs attending the ‗Most at Risk Population Initiative‘ clinics. The Luganda field testing showed that there were no missing data, the scale was well targeted, Cronbach‘s alpha was 0.82, weighted Kappa was 0.78, measurement was unidimensional, and all construct validity hypotheses were met. Likewise, with the Acholi, Lugisu, and Runyankole translations, field testing showed that there were no missing data, the scales were well targeted, Cronbach‘s alpha were>0.70, and measurement was unidimensional. We concluded that the Luganda LMUP is a valid and reliable tool for assessing pregnancy planning among FSWs in Uganda and that the Acholi, Lugisu, and Runyankole versions of the LMUP also had good initial psychometric properties. (Afr J Reprod Health 2019; 23[3]: 79-95).