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Sexual and reproductive health knowledge, contraception uptake, and factors associated with unmet need for modern contraception among adolescent female sex workers in China

(2015) PLOS ONE. 10(1).
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Abstract
Objective : In China, policy and social taboo prevent unmarried adolescents from accessing sexual and reproductive health (SRH) services. Research is needed to determine the SRH needs of highly disadvantaged groups, such as adolescent female sex workers (FSWs). This study describes SRH knowledge, contraception use, pregnancy, and factors associated with unmet need for modern contraception among adolescent FSWs in Kunming, China. Methods : A cross-sectional study using a one-stage cluster sampling method was employed to recruit adolescents aged 15 to 20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months. A semi-structured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression was conducted to determine correlates of low knowledge and unmet need for modern contraception. Results : SRH knowledge was poor among the 310 adolescents surveyed; only 39% had heard of any long-acting reversible contraception (implant, injection or IUD). Despite 98% reporting not wanting to get pregnant, just 43% reported consistent condom use and 28% currently used another form of modern contraception. Unmet need for modern contraception was found in 35% of adolescents, and was associated with having a current non-paying partner, regular alcohol use, and having poorer SRH knowledge. Past abortion was common (136, 44%). In the past year, 76% had reported a contraception consultation but only 27% reported ever receiving SRH information from a health service. Conclusions : This study demonstrated a low level of SRH knowledge, a high unmet need for modern contraception and a high prevalence of unintended pregnancy among adolescent FSWs in Kunming. Most girls relied on condoms, emergency contraception, or traditional methods, putting them at risk of unwanted pregnancy. This study identifies an urgent need for Chinese adolescent FSWs to be able to access quality SRH information and effective modern contraception.
Keywords
BEHAVIOR, TRANSMITTED INFECTIONS, VIOLENCE, WOMEN, HIV, DRINKING, ALCOHOL, KENYA, RISK

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Chicago
Lim, Megan SC, Xudong Zhang, Elissa Kennedy, Yan Li, Yin Yang, Lin Li, Yun-Xia Li, Marleen Temmerman, and Stanley Lüchters. 2015. “Sexual and Reproductive Health Knowledge, Contraception Uptake, and Factors Associated with Unmet Need for Modern Contraception Among Adolescent Female Sex Workers in China.” Plos One 10 (1).
APA
Lim, M. S., Zhang, X., Kennedy, E., Li, Y., Yang, Y., Li, L., Li, Y.-X., et al. (2015). Sexual and reproductive health knowledge, contraception uptake, and factors associated with unmet need for modern contraception among adolescent female sex workers in China. PLOS ONE, 10(1).
Vancouver
1.
Lim MS, Zhang X, Kennedy E, Li Y, Yang Y, Li L, et al. Sexual and reproductive health knowledge, contraception uptake, and factors associated with unmet need for modern contraception among adolescent female sex workers in China. PLOS ONE. 2015;10(1).
MLA
Lim, Megan SC, Xudong Zhang, Elissa Kennedy, et al. “Sexual and Reproductive Health Knowledge, Contraception Uptake, and Factors Associated with Unmet Need for Modern Contraception Among Adolescent Female Sex Workers in China.” PLOS ONE 10.1 (2015): n. pag. Print.
@article{5909382,
  abstract     = {Objective : In China, policy and social taboo prevent unmarried adolescents from accessing sexual and reproductive health (SRH) services. Research is needed to determine the SRH needs of highly disadvantaged groups, such as adolescent female sex workers (FSWs). This study describes SRH knowledge, contraception use, pregnancy, and factors associated with unmet need for modern contraception among adolescent FSWs in Kunming, China. 
Methods : A cross-sectional study using a one-stage cluster sampling method was employed to recruit adolescents aged 15 to 20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months. A semi-structured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression was conducted to determine correlates of low knowledge and unmet need for modern contraception. 
Results : SRH knowledge was poor among the 310 adolescents surveyed; only 39\% had heard of any long-acting reversible contraception (implant, injection or IUD). Despite 98\% reporting not wanting to get pregnant, just 43\% reported consistent condom use and 28\% currently used another form of modern contraception. Unmet need for modern contraception was found in 35\% of adolescents, and was associated with having a current non-paying partner, regular alcohol use, and having poorer SRH knowledge. Past abortion was common (136, 44\%). In the past year, 76\% had reported a contraception consultation but only 27\% reported ever receiving SRH information from a health service. 
Conclusions : This study demonstrated a low level of SRH knowledge, a high unmet need for modern contraception and a high prevalence of unintended pregnancy among adolescent FSWs in Kunming. Most girls relied on condoms, emergency contraception, or traditional methods, putting them at risk of unwanted pregnancy. This study identifies an urgent need for Chinese adolescent FSWs to be able to access quality SRH information and effective modern contraception.},
  articleno    = {0115435},
  author       = {Lim, Megan SC and Zhang, Xudong and Kennedy, Elissa and Li, Yan and Yang, Yin and Li, Lin and Li, Yun-Xia and Temmerman, Marleen and L{\"u}chters, Stanley},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  keyword      = {BEHAVIOR,TRANSMITTED INFECTIONS,VIOLENCE,WOMEN,HIV,DRINKING,ALCOHOL,KENYA,RISK},
  language     = {eng},
  number       = {1},
  pages        = {17},
  title        = {Sexual and reproductive health knowledge, contraception uptake, and factors associated with unmet need for modern contraception among adolescent female sex workers in China},
  url          = {http://dx.doi.org/10.1371/journal.pone.0115435},
  volume       = {10},
  year         = {2015},
}

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