Family Planning among Female Sex Workers Living with HIV in Tanzania

©CSK Research Solutions

The issue
In Tanzania, national guidelines recommend providing family planning (FP) and “safer pregnancy” counseling services for women living with HIV, as well as integrated reproductive health services for female sex workers (FSWs). However, there is no guidance on the provision of these broader FP services to HIV-positive women who sell sex.


Our approach
The aims of this study are to (1) describe HIV-positive FSWs’ fertility-related needs and desires (e.g., contraceptive need, fertility intentions, dual method use and acceptability); (2) describe and assess ongoing community-based FP services offered by local implementing partner, Jhpiego’s Sauti project; and (3) explore awareness, accessibility, and acceptability of safer conception strategies among HIV-positive FSWs who wish to get pregnant, and among Sauti healthcare providers. SOAR is employing mixed methods (i.e., consultation observations, quantitative client exit interviews, and qualitative provider and client interviews) to conduct a systematic assessment of Sauti community-based FP services for HIV-positive FSWs in Dar es Salaam. These activities also are providing empirical data on FP and safer conception desire and need among HIV-positive women who sell sex in the capital city. In addition to the Dar es Salaam data collection activities, SOAR is leveraging its evaluation of a community-based HIV treatment model for FSWs in Njombe and Mbeya to collect selected FP and safer conception data as part of the baseline survey administered among HIV-positive FSWs enrolled in that cohort study.


The impact
Collectively, this research will fill knowledge gaps regarding HIV-positive FSWs’ need for and desire to use contraception, fertility intentions, and knowledge of and access to safer conception services. Findings also will provide globally and nationally relevant insights into how to meet the comprehensive FP needs of HIV-positive women who sell sex, as well as HIV-positive women in general. This research will inform programmatic efforts to reduce mother-to-child HIV transmission, and help women plan whether and when to have children.