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Background <p>Sub-Saharan Africa has a high prevalence of pregnancy among female sex workers (FSWs). Understanding FSWs’ pregnancy intentions and how they affect pregnancies can help prevent unintended pregnancies (UP) and poor pregnancy outcome. This study investigates factors associated with pregnancy and outcomes among FSWs in Cameroon.</p> Methods <p>A cross-sectional study was conducted in FSWs aged 18 to 49 years. Participants were recruited through voluntary sampling in eight community-based organisations across five towns in Cameroon during July 2023. The three outcomes were pregnancy, UP and poor pregnancy outcome within the last twelve months. A binary logistic regression using SPSS 27 with backward Wald’s method and Robust (modified) Poisson Regression was performed to identify factors associated with the outcomes of interest.</p> Results <p>A total of 481 female sex workers (FSWs) with a median age of 24 years were recruited for the study. Among them, 101 (21%) experienced at least one pregnancy during the last twelve months, of which 34 (33.7%) was UP. Among those who reported pregnancy, 53.5% (54/101) had a live birth versus 20.6% (7/34) for those who experienced UP. FSWs aged &gt; = 25 years (Vs &lt; = 24 years) were less likely to experience pregnancy (aOR = 0.49, 95% CI: 0.29–0.83) and those who abuse of at least one psychoactive substance (PAS) were more likely to have at least one pregnancy (aOR = 1.91, 95% CI: 1.002–3.65). UP was lower among those who had another source of income than prostitution (aRR = 0.39, 95% CI: 0.15–0.98). The risk of poor pregnancy outcome increases by almost 3 (aRR = 2.66, 95% CI: 1.76-4.00) for FSWs who faced UP.</p> Conclusion <p>Among FSWs in Cameroon, younger age (&lt; 25 years), positive pregnancy intention, and psychoactive substance use were all significantly associated with higher odds of experiencing pregnancy in the past twelve months. Additionally, unintended pregnancy more than doubled the risk of a poor pregnancy outcome (abortion or miscarriage). These findings underscore the urgent need for targeted interventions promoting consistent contraceptive use and addressing substance use—especially among younger FSWs who intend pregnancy—to reduce unintended pregnancies and related adverse outcomes.</p>

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Prevalence of pregnancy, unintended pregnancy, poor pregnancy outcome and its associated factors among female sex workers in Cameroon

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  • 发表日期：

    2025年7月28日

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  • Jean-Pierre Yves Awono Noah,
  • Justin Ndié,
  • Clifford Muluh,
  • Rogacien Kana Dongmo,
  • Francis Ateba Ndongo,
  • Félicité Naah Tabala,
  • Jean De Dieu Anoubissi,
  • Martial Guengang Tedongmo,
  • Yembe Njamnshi Wepnyu,
  • Martial Aimé Bonyohe,
  • Jaures Metambou,
  • Yvette Ndjatte Heuya,
  • Zacheaus Zeh Akiy,
  • Iris Kuoh Ebongue,
  • Carrine Angumua,
  • Albert Zeh Meka,
  • Basile Keugoung,
  • Joseph Fokam,
  • Jérôme Ateudjieu,
  • Anne Cécile Zoung-Kanyi Bissek

摘要

Background

Sub-Saharan Africa has a high prevalence of pregnancy among female sex workers (FSWs). Understanding FSWs’ pregnancy intentions and how they affect pregnancies can help prevent unintended pregnancies (UP) and poor pregnancy outcome. This study investigates factors associated with pregnancy and outcomes among FSWs in Cameroon.

Methods

A cross-sectional study was conducted in FSWs aged 18 to 49 years. Participants were recruited through voluntary sampling in eight community-based organisations across five towns in Cameroon during July 2023. The three outcomes were pregnancy, UP and poor pregnancy outcome within the last twelve months. A binary logistic regression using SPSS 27 with backward Wald’s method and Robust (modified) Poisson Regression was performed to identify factors associated with the outcomes of interest.

Results

A total of 481 female sex workers (FSWs) with a median age of 24 years were recruited for the study. Among them, 101 (21%) experienced at least one pregnancy during the last twelve months, of which 34 (33.7%) was UP. Among those who reported pregnancy, 53.5% (54/101) had a live birth versus 20.6% (7/34) for those who experienced UP. FSWs aged > = 25 years (Vs < = 24 years) were less likely to experience pregnancy (aOR = 0.49, 95% CI: 0.29–0.83) and those who abuse of at least one psychoactive substance (PAS) were more likely to have at least one pregnancy (aOR = 1.91, 95% CI: 1.002–3.65). UP was lower among those who had another source of income than prostitution (aRR = 0.39, 95% CI: 0.15–0.98). The risk of poor pregnancy outcome increases by almost 3 (aRR = 2.66, 95% CI: 1.76-4.00) for FSWs who faced UP.

Conclusion

Among FSWs in Cameroon, younger age (< 25 years), positive pregnancy intention, and psychoactive substance use were all significantly associated with higher odds of experiencing pregnancy in the past twelve months. Additionally, unintended pregnancy more than doubled the risk of a poor pregnancy outcome (abortion or miscarriage). These findings underscore the urgent need for targeted interventions promoting consistent contraceptive use and addressing substance use—especially among younger FSWs who intend pregnancy—to reduce unintended pregnancies and related adverse outcomes.