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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

Megan SC Lim, Xudong Zhang, Elissa Kennedy, Yan Li, Yin Yang, Lin Li, Yun-Xia Li, Marleen Temmerman UGent and Stanley Lüchters UGent (2015) PLOS ONE. 10(1).
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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
BEHAVIOR, TRANSMITTED INFECTIONS, VIOLENCE, WOMEN, HIV, DRINKING, ALCOHOL, KENYA, RISK
journal title
PLOS ONE
PLoS One
volume
10
issue
1
article number
0115435
pages
17 pages
Web of Science type
Article
Web of Science id
000348821400008
JCR category
MULTIDISCIPLINARY SCIENCES
JCR impact factor
3.057 (2015)
JCR rank
11/63 (2015)
JCR quartile
1 (2015)
ISSN
1932-6203
DOI
10.1371/journal.pone.0115435
language
English
UGent publication?
yes
classification
A1
additional info
the first two authors contributed equally to this work
copyright statement
I have retained and own the full copyright for this publication
id
5909382
handle
http://hdl.handle.net/1854/LU-5909382
date created
2015-03-23 15:29:07
date last changed
2016-12-21 15:42:41
@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},
}

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.