The Practice and Challenges of Commercial Sex Workers in Accessing Reproductive Health Needs: the Case of Family Guidance Association of Ethiopia Adama Confidential Clinic in Adama Town, East Shoa Zone Oromia Region

Abstract

Globally and in Ethiopia commercial sex workers (CSWs) are considered a most – at –risk population (MARPS) for RH problems, and their clients play an important role in the spread of HIV STI infections to the general population. Survey of Ethiopia CSWs including biomarker data demonstrated that this population is disproportionally exposed to reproductive health problems. Commercial sex workers face cultural, social, legal and linguistic obstacles to accessing services and information. Equally important, many women in sex work experience violence on the streets, on the job or in their personal lives which increases their vulnerability to HIV and other health concerns. The purpose of this study was to explore the practices, challenges and the factors which lead sex workers in reproductive health problems and to examine the availability, accessibility and utilization of SRH services in the case of FGAE Adama Confidential Clinic clients.The study participants were sampled using simple random sampling technique were employed. Qualitative research design was employed in order to answers a wide variety of questions related to sex workers responses to actual or potential health and behavioral problems. In this case, a cross-sectional study was also employed to describe the relationship between sex work practice and associated effects. The result of the study showed those majority age groups were 15 – 24 years 18 respondents which is the major proportion 69.2% were within this age, and most of them were never married, financial drive which comprises the highest proportion 40% of coverage often pushes young ladies into sex work. Most of them agreed that they lack basic knowledge and information about safe sex practices, how to prevent STI, HIV and unwanted pregnancy. This showed that the potential transmission of STI is very high and also this can increase the possibility of acquiring the HIV/ AIDS. Unwanted pregnancies are also the most frequent and series problems of them. Sometimes they did not know when and from whom they had sex and got pregnant. Different reasons were mentioned by SWs, they usually used condoms as a means of protection from pregnancy and other infectious diseases, but because of condom breakage and slippage they exposed to unplanned pregnancy they also mentioned that these all problems leads to emotional and behavioral problems. Socioeconomic and cultural factors, low health seeking behavior, lack of access and unfriendly health services are the factors that lead them to RH problems. To conclude, it is important that steps to be taken to improve on the level of awareness on RH among the respondents. The results clearly points out important lessons for health education. This should target the perceptual factors, which tended to provide adequate explanation for the knowledge on modes of transmission, prevention and practices of the respondents towards RH. The high prevalence of STI HIV infection in this target groups in the town and the commercial sex workers demand for SRH services confirm the need to provide these services in the holistic approach. Moreover it is not only accessing and availing the RH services but also making the services friendly is principal importance for commercial sex workers to use the SRH services.