Pregnancy intentions and safer pregnancy knowledge among female sex workers in Port Elizabeth, South Africa

Amrita Rao, Stefan Baral, Nancy Phaswana-Mafuya, Andrew Lambert, Zamakayise Kose, Mfezi Mcingana, Claire Holland, Sosthenes Ketende, Sheree Schwartz

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


OBJECTIVE: To assess the association between human immunodeficiency virus (HIV) and pregnancy intentions and safer conception knowledge among female sex workers in Port Elizabeth, South Africa. METHODS: This cross-sectional study recruited female sex workers in Port Elizabeth using respondent-driven sampling and completed an interviewer-administered questionnaire alongside HIV testing and counseling. In this secondary analysis, robust Poisson regression was used to model prevalence ratios for positive fertility intentions in this cross-sectional study. Knowledge of safer conception methods by HIV status was compared using Fisher exact tests. RESULTS: Overall 391 women were represented in the analyses. More than 50% had a prior HIV diagnosis, and an additional 12% were diagnosed with HIV during the study. Approximately half (n185) of the women reported future pregnancy intentions. In univariate analysis, a prior HIV diagnosis was negatively associated with pregnancy intentions as compared with HIV-negative women (prevalence ratio 0.68, 95% confidence interval 0.55-0.85). Only parity remained independently associated with future pregnancy intentions in multivariate regression after controlling for HIV status, age, race, relationship status, and years selling sex. Knowledge of safer conception methods such as timed sex without a condom, preexposure prophylaxis, or self-insemination was low and similar between those with and without future pregnancy plans. CONCLUSION: Pregnancy intentions did not significantly vary according to HIV status. Fertility intentions were high, however, and knowledge of safer conception methods low, suggesting a need to provide female sex workers with advice around options to conceive safely in the context of high HIV prevalence.

Original languageEnglish (US)
Pages (from-to)15-21
Number of pages7
JournalObstetrics and gynecology
Issue number1
StatePublished - Jul 1 2016

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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