Sexual and Reproductive Health Service Needs Associated with Underage Initiation of Selling Sex among Adult Female Sex Workers in Guinea-Bissau

Ashley Grosso (), Lindsay Berg, Katherine Rucinski, Amrita Rao, Mamadú Aliu Djaló, Daouda Diouf and Stefan Baral
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Ashley Grosso: Department of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ 07102, USA
Lindsay Berg: Center for Population Behavioral Health, Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ 08901, USA
Katherine Rucinski: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
Amrita Rao: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
Mamadú Aliu Djaló: Enda Santé, Guiné-Bissau, Bissau 1041, Guinea-Bissau
Daouda Diouf: Enda Santé, Dakar 3370, Senegal
Stefan Baral: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA

IJERPH, 2022, vol. 19, issue 19, 1-12

Abstract: Objective: To assess the prevalence and predictors of underage initiation of selling sex among female sex workers (FSW) in Guinea-Bissau. Methods: 505 adult FSW recruited using respondent-driven sampling were surveyed in 2017. Multivariable logistic regression was used to identify demographic, behavioral, and psychosocial characteristics associated with initiation of selling sex while underage (<18 years). Results: A total of 26.3% (133/505) of FSW started selling sex before age 18. Underage initiation of selling sex was associated with experiencing forced sex before age 18 (adjusted odds ratio (aOR): 6.74; 95% confidence interval (CI): 2.05–22.13), and never being tested for HIV (aOR: 0.43; 95% CI: 0.20–0.91). Despite having lower odds of wanting to have children or more children (aOR: 0.31; 95% CI: 0.17–0.56), FSW who started selling sex while underage had lower odds of using highly effective contraception such as implants (aOR: 0.43; 95% CI: 0.24–0.77). Among those who were ever pregnant, a lower percentage of FSW who started selling sex while underage accessed antenatal care (56.6% vs. 74.7%, p = 0.008). Conclusions: These data suggest that early initiation of selling sex among adult FSW in Guinea-Bissau is common. Social services for youth and integrated HIV and reproductive health services are critical to address the persisting sexual and reproductive health needs of FSW who started selling sex while underage.

Keywords: female sex workers; Guinea-Bissau; minors; adolescents; reproductive health; sexual health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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