Nutritional status and its associated factors among commercial female sex workers in Hawassa city, south Ethiopia
- PMID: 37138815
- PMCID: PMC10150714
- DOI: 10.7717/peerj.15237
Nutritional status and its associated factors among commercial female sex workers in Hawassa city, south Ethiopia
Abstract
Background: Commercial female sex workers (CFSWs) regularly or occasionally trade sex for money. Sex work is widespread, mainly in urban areas of Ethiopia. The study on the nutritional status of CFSWs is unavailable in Ethiopia, and data are also scanty at the global level. This study aims to assess nutritional status and associated factors among CFSWs in Hawassa city, Ethiopia.
Methods: This cross-sectional study used facility-based mixed data collection methods (qualitative and quantitative). The study was conducted in three key population clinics in Hawassa city. A total of 297 CFSWs were randomly selected for the 'quantitative survey,' and twelve (n = 12) purposively selected participants were involved in the 'qualitative study.' Body mass index/BMI (Kg/m2) was used in assessing the nutritional status of CFSWs. Statistical software packages were used for analyzing both quantitative and qualitative data. Significant variables (P<0.05) in bivariate analysis (Chi-square test) were incorporated in the multivariable analyses. Multinomial logistic regression (MNLR) was employed where dependable variable like 'normal BMI' (18.5-24.9 kg/m2) was set as a reference category and simultaneously compared with 'underweight' (<18.5 BMI) and 'overweight/obesity' (≥ 25 BMI) categories. Thus, two models, namely the underweight model (model-1: Underweight versus normal BMI) and the overweight/obesity model (model-2: overweight/obesity versus normal), were generated.
Results: The prevalence of underweight and overweight/obesity among CFSWs in Hawassa city were respectively 14.1% and 16.8%. Living alone (Adjusted odds ratio/AOR = 0.18), chewed Khat regularly (AOR = 0.23), used drugs regularly (AOR = 10.57), used drugs in exchange of sex (AOR = 4.97), and HIV positive status (AOR = 21.64) were significantly (P < 0.05) associated with underweight (model-1). In the overweight/obesity model-2, having jobs other than sex work (AOR = 0.11), higher daily mean income (AOR = 3.02), being hotel/home-based CFSWs (AOR = 12.35), and presence of any chronic illness (AOR = 5.15) were significant (P < 0.05) predictors of overweight/obesity. From the 'qualitative part' of this study, it was also revealed that 'lack of food and money' was the main influencing factor among CFSWs to enter into the sex business.
Conclusions: Commercial female sex workers in this study faced a double burden of malnutrition. Multiple factors influenced their nutritional status. Substance abuse and HIV-positivity are the most significant predictors of being underweight and having higher income, being hotel/home-based CFSWs, and suffering from any chronic illness are associated with overweight/obesity. Government and other partners should be essential in providing comprehensive programs focusing on sexual, reproductive health, and nutrition education. Steps should be taken to improve their socioeconomic status and strengthen those good initiatives at key population clinics and other health facilities.
Keywords: Commercial female sex workers; Ethiopia; Nutritional status; Obese; Overweight; Underweight.
©2023 Gelan et al.
Conflict of interest statement
The authors declare there are no competing interests.
Figures
Similar articles
-
Double Burden of Malnutrition among Female Adolescent Students in Bahir Dar City, Amhara, Ethiopia.Biomed Res Int. 2020 Aug 15;2020:6249524. doi: 10.1155/2020/6249524. eCollection 2020. Biomed Res Int. 2020. PMID: 32879884 Free PMC article.
-
Rural-urban disparities in nutritional status among women in Ethiopia based on HIV serostatus: a cross-sectional study using demographic and health survey data.BMC Infect Dis. 2023 Aug 21;23(1):544. doi: 10.1186/s12879-023-08490-8. BMC Infect Dis. 2023. PMID: 37605115 Free PMC article.
-
Assessment of exposure to sexually explicit materials and factors associated with exposure among preparatory school youths in Hawassa City, Southern Ethiopia: a cross-sectional institution based survey.Reprod Health. 2015 Sep 14;12:86. doi: 10.1186/s12978-015-0068-x. Reprod Health. 2015. PMID: 26370668 Free PMC article.
-
Fertility is a key predictor of the double burden of malnutrition among women of child-bearing age in sub-Saharan Africa.J Glob Health. 2020 Dec;10(2):020423. doi: 10.7189/jogh.10.020423. J Glob Health. 2020. PMID: 33110582 Free PMC article. Review.
-
Body size preferences for women and adolescent girls living in Africa: a mixed-methods systematic review.Public Health Nutr. 2022 Mar;25(3):738-759. doi: 10.1017/S1368980021000768. Epub 2021 Feb 17. Public Health Nutr. 2022. PMID: 33593472 Free PMC article. Review.
Cited by
-
Khat consumption and undernutrition among adult population in Ethiopia: A systematic review and meta-analysis.PLoS One. 2024 Apr 23;19(4):e0299538. doi: 10.1371/journal.pone.0299538. eCollection 2024. PLoS One. 2024. PMID: 38652725 Free PMC article.
References
-
- Anderson CJ, Rutkowski L. Multinomial logistic regression. In: Osborne J, editor. Best practices in quantitative methods. Washington DC, United States: SAGE Publishing; 2008. pp. 390–409. - DOI
-
- Bagley C, Kadri S, Shahnaz A, Simkhada P, King K. Commercialized sexual exploitation of children, adolescents and women: health and social structure in Bangladesh. Advances in Applied Sociology. 2017;7:137–150. doi: 10.4236/aasoci.2017.74008. - DOI
-
- CECR . Geneva: CECR; 2016. General comment No. 22 on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social, and Cultural Rights)
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources