Reproductive History and Pregnancy Incidence of Malian and Beninese Sex Workers Before and Suring Sex Work Practice
Bibliographic record
Abstract
Abstract BACKGROUND: To reduce maternal mortality, access to family planning and reproductive health care services is a key strategy. Access to and use by marginalized populations pose a substantial challenge. Sex workers in sub-Saharan Africa are a good example. The objective of this study was to describe the reproductive history of female sex workers (FSWs) before and during sex work.METHODS: FSWs aged ≥18 years were recruited in Cotonou (Benin), and Bamako (Mali), to answer a face-to-face questionnaire inquiring on reproductive history. Descriptive analyses were carried out and comparisons made between countries using Pearson chi-square and between the periods before (BSW) and during sex work (DSW) practice within women in each country using McNemar chi-square. In addition, multiple imputations were used to estimate and compare the incidence rate of pregnancy BSW and DSW.RESULTS: Mean age was 26 years in Mali (n=322) and 35 years in Benin (n=330). More women had at least one pregnancy BSW compared to DSW in both Mali (62.1% vs 33.5%) and Benin (91.2% vs 32.7%). The pregnancies occurring DSW had lower livebirth rates (57.9% vs 74.7% - Mali, 17.6% vs 60.6% - Benin) and ended more often with a therapeutic abortion, DSW compared to BSW, especially in Benin (65.2% vs 25.6%). The level of complications associated with therapeutic abortion was high, both DSW (23%) and BSW (20%). The incidence rate of pregnancy was about twice lower DSW compared to BSW [incidence rate ratio (IRR): 0.49; 95% confidence interval (95%CI): 0.37-0.66 in Mali and IRR: 0.45; 95% CI: 0.32-0.63 in Benin].CONCLUSION: In both Benin and Mali, FSWs had more pregnancies during the period preceding sex work practice, about twice more than during sex work when considering the differences in incidence rates. Single mothers need to be supported to avoid sex work as a financial solution. On the other hand, the reproductive needs of FSWs need to be acknowledged to reduce maternal mortality within this marginalized population. It is of paramount importance that interventions remain focused on reproductive health and prevent unwanted pregnancies, answer contraceptive needs and provide safe therapeutic abortions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".