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Research and programs for female sex workers FSWs tend to focus exclusively on HIV prevention, with little attention paid to how pregnancy affects their lives. We examine the circumstances surrounding pregnancy and childbirth among women selling sex in Ethiopia. The women reported on pregnancies experienced both before and after they had begun selling sex.
They identified some of the fathers as clients, former partners, and current partners, but they did not know the identities of the other fathers. Missed injections, skipped pills, and inconsistent condom use were causes of unintended pregnancy.
Abortion was common, typically with a medication regimen at a facility. Comprehensive sexual and reproductive health services should be provided to women who sell sex, in recognition and support of their need for family planning and their desire to plan whether and when to have children.
As a result, research and programs among this population typically focus exclusively on reducing HIV risk behaviors, with an emphasis on HIV testing and promotion of condom use. Not all FSWs aspire to space or limit pregnancy, however. Programs for these women that solely emphasize increasing and measuring condom use run the risk of neglecting their basic family planning needs and fertility desires.
The complex relationship contexts in which FSWs experience pregnancy create substantial challenges to researchers who seek to examine their fertility desires and family planning behaviors across multiple partners.