Browsing by Author "Laker, Fiona Gladys"

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    Dual contraceptive use and associated factors among female sex workers in Gulu City, Uganda in 2023
    (BioMed Central, 2023-08-16) Bongomin, Felix; Pebalo, Francis Pebolo; Kibone, Winnie; Okwir Apio, Pamela; Nsenga, Lauryn; Okot, Jerom; Madraa, Grace; Laker, Fiona Gladys; Akello, Martha; Ouma, Simple; Musoke, David
    Background: Dual contraception is an essential approach to mitigating the heightened risks of unintended pregnancies and sexually transmitted infections faced by female sex workers (FSWs). We determined the prevalence and factors associated with dual contraceptive use among FSWs in Northern Uganda. Methods: A cross-sectional study was conducted in Gulu city, Uganda between February, and March 2023. Purposively selected FSWs aged 18 years or older who provided verbal informed consent were enrolled in the study. A sample size of 374 was estimated. Data on sociodemographic and reproductive health characteristics were collected using an interviewer-administered semi-structured questionnaire. Current dual contraception was defned the as concurrent use of a barrier and any other modern contraceptive methods within the last 3 months. Continuous variables were summarized using mean and standard deviation and categorical variables were summarized using frequencies and percentages. Modifed Poisson regression analysis was used to determine factors associated with dual contraceptive use. Results: We enrolled 314 FSWs, with a mean age of 28.8±6.4 years. About 13.8% (n=41) were living with HIV. In total, 66.2% (95%CI 60.8–71.3) of the participants (n=208) reported current dual contraceptive use. The most common modern contraceptive method used was the implants (52.4%, n=109), followed by injectable contraceptives (22.6.0%, n=47), and bilateral tubal ligation (0.5%, n=1) was the least utilized. Having had at least one previous pregnancy was positively associated with dual contraceptive use (adjusted PR: 1.87, 95%CI 1.40–2.51, p<0.001). Conclusions: A high proportion of FSWs in Gulu city were currently using dual contraceptives. Interventions are needed to facilitate the use of dual contraception, particularly among FSWs without a history of previous pregnancies.
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    “I Use Strawberry Flavoured Condoms during My Periods”:
    (MDPI, 2023-08-28) Bongomin, Felix; Kibone, Winnie; Pebalo, Francis Pebolo; Laker, Fiona Gladys; Okot, Jerom; Kaducu, Felix Ocaka; Madraa, Grace; Labongo Loum, Constantine Steven; Awor, Silvia; Napyo, Agnes; Musoke, David; Ouma, Simple
    Background: Female sex workers (FSWs) are at a higher risk of contracting and transmitting HIV and other sexually transmitted infections (STIs). We aimed to explore the sexual behaviour, knowledge and attitudes towards STIs, barriers, support and intervention for STI screening. Methods: In this community-based, concurrent quantitative–qualitative, exploratory mixed-methods study, we administered 87 semi-structured quantitative and six in-depth interviews to purposively select FSWs in Gulu City, Uganda. The qualitative methodology was based on descriptive phenomenology. Results: The quantitative study included 87 FSWs, with a median age of 28 years. Overall, 87.4% (n = 76) participants reported condom use during their last sexual encounter. Eighty-three (95.4%) participants were aware of their HIV status, with 6% (n = 5) reporting being HIV-positive. Seventy-six (87.4%) participants reported contracting at least one STI during sex work. In addition, 66.7% (n = 58) of the participants reported being screened for STIs in the past three months, with vulvovaginal candidiasis (55.3%, n = 42) and syphilis (32.9%, n = 25) being the most common STIs. However, only 2.3% (n = 2) of the participants reported current STIs symptoms. In the qualitative study, the main themes encompassed sexual behaviour, including condom-use negotiation strategies and challenges, as well as screening facilitators and barriers. Condom-use negotiation tactics involved leveraging healthrisk information, increased charges for unprotected sex, and outright refusal. Complex challenges included limited agency in promoting safe sex due to economic reliance, vulnerability to violence, and difficulties in controlling the sexual environment. Facilitators for regular screening included social influences, emotional relief, established testing habits, and accessible clinics, while barriers encompassed cost, stigma, doubts about test accuracy, and inconvenient clinic hours. Conclusions: FSWs face significant vulnerabilities in Gulu City, Uganda, regarding STIs. While encouraging trends such as high HIV awareness and condom usage were observed, persistent challenges in STI screening, negotiation of safe sex practices, and access to prevention and treatment remain evident. To address these concerns, targeted interventions should be developed to enhance STI screening accessibility empower sex workers with effective negotiation skills, and provide comprehensive support for STI prevention and treatment, thereby contributing to improved overall sexual health and well-being among this marginalized population
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    “We provide the methods to others but we don’t use the methods ourselves”: challenges with utilization of modern contraception among Female Healthcare Workers at two tertiary teaching hospitals, Northern Uganda
    (Contraception and Reproductive Medicine, 2024-10-31) Opee, Jimmy; Opiro, Keneth; Manano, Priscilla; Sikoti, Margret; Ayikoru, Jackline; Akello, Harriet; Laker, Fiona Gladys; Wolters, K. Maria; Awor, Silvia; Pebalo Pebolo, Francis; Bongomin, Felix
    Background Female Healthcare Workers (FHCWs) play a crucial role in advocating for, delivering modern contraceptive methods (MCM) to reproductive-age women and potential users. Despite the high frequency of women seeking healthcare annually, less than half receive adequate contraceptive counseling and services. Investigating FHCWs’ adherence to these practices and understanding the obstacles they encounter is essential. This study aimed to explore challenges with utilization of MCM among FHCWs at the two tertiary teaching hospitals in Northern Uganda. Methods We conducted a descriptive, cross-sectional study employing a qualitative approach at St. Mary’s Hospital Lacor (SMHL) and Gulu Regional Referral Hospital (GRRH), Northern Uganda. Qualitative data were explored using the principles of descriptive phenomenology to gain deeper insights into the experiences of twenty (20) FHCWs. Results Findings revealed various challenges faced by FHCWs, including patient barriers such as religious beliefs, contraceptive myths, fear of side effects, and provider barriers like lack of knowledge, training, and discomfort. Additionally, health system barriers like limited time and competing priorities were identified. Conclusion Female Healthcare workers experience challenges with utilization of MCM. Efforts should focus on enhancing contraceptive services, particularly in faith-based facilities and among married individuals. Besides, addressing perceived barriers at the patient, provider, and system levels through comprehensive health education, ensuring method availability, and provider training is imperative.