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Then, get ready to escape the ordinary and experience an hour, day or week of complete pleasure, intimacy and companionship with one of the most desirable escorts in Mbuguni A novel safer conception counseling Prostitutes Mbuguni for the prevention of HIV: a mixed-methods evaluation in Kisumu, Kenya. These services include HIV testing and counseling, gender-based Prostitutes Mbuguni services, sexually transmitted infection screening and treatment, alcohol and drug screening, and FP counseling and methods.

Results Median age of participants was Nearly one-third wished to have a child within two years. Seventy-two percent had heard of having the HIV-positive partner taking ART to reduce sexual transmission Prostitutes Mbuguni pregnancy attempts.

Viral suppression was not associated with fertility desire. This integrated service delivery modality is a promising platform for providing safer conception services. Sauti staff then enlisted FSW peer educators to contact and Prostitutes Mbuguni eligible women to participate in the study. The peer educators invited the women to attend a health consultation at one of five Sauti community-based service delivery sites in Kinondoni and Temeke Prostitutes Mbuguni in Dar es Salaam. The five study sites were in Bunju, Kawe, and Tandale wards in Kinondoni district; and in Keko and Membweyanga wards in Temeke district.

Women were attending services at the invitation of the study team, so they were not necessarily proactively seeking Prostitutes Mbuguni for a Prostitutes Mbuguni concern—whether FP or any other issue—at the time of the consultations. Upon presenting at the study sites, the potential participant underwent a health consultation with the Sauti provider.

Afterwards, an interviewer administered screening questions to ensure that the woman met the inclusion criteria. If the woman was eligible, the interviewer conducted the informed consent process with the potential participant.

The interviewer then proceeded to administer a questionnaire on tablets using an open-source electronic data collection software program, KoBo Toolbox www. Prior to initiating data collection, the study team translated the survey from English to Kiswahili. To ensure face validity of the survey i. The research team conducted descriptive analyses of the exit interview data, calculating Prostitutes Mbuguni frequencies to describe the demographic characteristics of participants, as well as their fertility-related needs and knowledge, including awareness of and interest in safer conception strategies.

Participants were defined as consistent condom users if they Prostitutes Mbuguni that they always used condoms in the past month with both paying clients and Prostitutes Mbuguni partners. Use of other, non-condom modern methods i. Desire for children was defined using the standard demographic definition of fertility desire: wanting to have a child within two years. Specifically, all participants were asked whether they were aware of strategies to get pregnant more safely and have a safer pregnancy as women living with HIV.

For each of the following methods, please tell me if you are aware of each strategy Prostitutes Mbuguni trying to get pregnant more safely. In addition, to specifically assess whether viral load testing, viral suppression, and awareness of safer conception strategies were associated with fertility desire, we included these variables in the Prostitutes Mbuguni model.

Of the women invited by peer Prostitutes Mbuguni to participate in the study, 39 were found to be ineligible upon screening by interviewers at study sites. After omitting ineligible women, the exit interview sample consisted of participants.

Twenty-three percent said that they always used condoms with sexual partners paying and non-paying in the past month. When asked to specify which Prostitutes Mbuguni they had heard of for people living with HIV to get pregnant more safely, nearly three-quarters said they had heard of having the seropositive partner taking ART. Ninety percent recognized at least one of Prostitutes Mbuguni safer conception strategies.

In bivariate analysis, older women had marginally Prostitutes Mbuguni odds of desiring a child within two years odds ratio [OR] 0.

Likewise, those who had a greater number of living children Prostitutes Mbuguni significantly lower odds of Prostitutes Mbuguni a child OR 0. Desire for children was positively associated with having had a nonpaying partner in the past three months OR 2.

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In bivariate analysis, desire for children was not significantly associated with education level, having received a viral load test in the past six months, self-reported viral suppression, use of modern contraception, or awareness of at least one safer conception strategy. In multivariate analysis, the only factors that were significantly associated with Prostitutes Mbuguni for children were having a nonpaying partner adjusted odds ratio [AOR] 2.

This study corroborates and substantiates the burgeoning research documenting the desire for children among women living with HIV, and the Prostitutes Mbuguni need and opportunity to provide explicit safer conception counseling and services to these Prostitutes Mbuguni [ 1 — 7 ].

At minimum, a FP discussion presents a teachable opportunity to impress upon HIV-positive women that there are effective biomedical and behavioral strategies that can, in some cases, Prostitutes Mbuguni eliminate the possibility of transmitting HIV to a partner or to an infant.

Some of these strategies—such as sperm washing—are not Prostitutes Mbuguni available for most HIV-positive women in Tanzania [ 57 ], but ART adherence and timed condomless sex are arguably readily accessible as safer conception options. The finding that those who wanted children imminently were no more likely to report viral suppression is concerning.

One would hope that women living with HIV who are contemplating pregnancy would Prostitutes Mbuguni aware of and supported to achieve viral suppression to minimize risk of HIV transmission to a seronegative partner. Furthermore, informing HIV-positive women of the possibility of having a safe pregnancy has the potential to motivate her to remain on treatment and seek Prostitutes Mbuguni antenatal care.

Study participants were not only women living with HIV, but they were also women who sell sex.

Due to both internal and external stigma, both women and providers alike may believe that HIV-positive FSWs are inherently uninterested in or unfit to have children, but our study findings demonstrate that a sizable proportion of these women aspire to become mothers, or complete their families among those who already are mothers. Notably, Cernigliaro and colleagues [ 58 ] reported that, among Prostitutes Mbuguni in the Dominican Republic, internalized stigma was associated with greater fertility desire; becoming a mother may Prostitutes Mbuguni these marginalized women with a sense of self-worth and acceptance [ 58 ].

The finding that those with Prostitutes Mbuguni partners have a higher odds of wanting children is intuitive, since these nonpaying partners often are men with whom FSWs have more intimate relationships than with paying clients. Findings from previous research supports this hypothesis; some FSWs report less consistent condom use with nonpaying partners because they feel that condoms compromise the intimacy of the sexual relationship, or they aspire to get pregnant with those partners [ 5960 ].

As articulated cogently by Ippoliti and colleaguesfemale key populations such as FSWs have a host of sexual and reproductive health needs, among which safer Prostitutes Mbuguni services often are neglected [ 61 ]. Results should be interpreted with the study context and limitations in mind.

Sauti community-based sites offer Prostitutes Mbuguni range of services beyond Prostitutes Mbuguni, and study participants were not necessarily proactively seeking FP counseling. In addition, to contextualize the low reported prevalence of recent viral load testing and self-reported viral suppression, it is worth underscoring that women are recommended to receive viral load testing within six months of treatment initiation, and once a year thereafter.

In addition, viral load testing may not always be available due to, for example, reagent stockouts or insufficient maintenance Prostitutes Mbuguni viral load testing machines.

Nevertheless, the finding that there was no significant correlation between fertility desire and either of these measures remains concerning. Moving forward, providers would benefit from Prostitutes Mbuguni about the minimum FP screening and counseling that they Prostitutes Mbuguni offer at every clinical interaction with HIV-positive women, with explicit consideration of how to address the possibility Prostitutes Mbuguni having children in the future.

Policymakers and service delivery organizations in Tanzania and elsewhere can consider building on existing national guidelines from South Africa, Prostitutes Mbuguni statements from safer conception researchers and advocates for people living with HIV PLHIVand a safer conception toolkit that has been tested in Kenya, for instance [ 19 Prostitutes Mbuguni, 17 ]. In addition, Prostitutes Mbuguni PrEP Prostitutes Mbuguni available more widely, this may present an opportunity to Prostitutes Mbuguni the acceptability of pre-conception PrEP for seronegative partners in mixed-status relationships.

Adolescent girls and young women remain disproportionately burdened by HIV in sub-Saharan Africa, and as they age into their reproductive years, the question of whether and how to have children will become increasingly salient. As demonstrated by our findings, FSWs are no exception to this reality. The growing consensus among researchers and advocates alike is that there is an urgent need for policies and programs to help HIV-positive women achieve pregnancy, while minimizing HIV risk [ 1 ].

This study was made possible by the women and providers who generously shared their time and experiences with the study team, as well as the peer educators who supported the recruitment of study participants. We also thank the CSK interviewers and observers for their diligent data collection efforts. Browse Subject Areas?

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Click through Prostitutes Mbuguni PLOS taxonomy to find articles in your field. Abstract Background With the advent of effective treatment, women living with HIV can plan for pregnancy while minimizing risk of transmission to infants and seronegative partners. Results Median age of participants was Materials and methods Setting Study sites were existing Sauti community-based service delivery points in Dar es Salaam.

Data collection activities The cross-sectional study design consisted of multiple Prostitutes Mbuguni collection activities at or near selected community-based FP service delivery sites for FSWs living with HIV in Dar es Salaam run by Sauti.

Client exit interviews. Variables and data analysis The research team conducted descriptive analyses of the exit interview data, calculating simple frequencies to describe the demographic characteristics of participants, as well as their fertility-related needs and knowledge, Prostitutes Mbuguni awareness of Prostitutes Mbuguni interest in safer conception strategies.

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Results Prostitutes Mbuguni the women invited by Prostitutes Mbuguni educators to participate in the study, 39 were found Prostitutes Mbuguni be ineligible upon screening by interviewers at study sites.

Download: PPT. Table 1. Table 2. Discussion This study corroborates and substantiates the burgeoning research documenting the desire for children among women living with HIV, and the indisputable need and opportunity to provide explicit safer conception counseling and services to these women [ 1 — 7 ].

Supporting information. S1 File. Client exit interview survey instrument—English.

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S2 File. Client exit interview survey instrument—Kiswahili. Acknowledgments This study was made possible by the women and providers who generously shared their time and experiences Prostitutes Mbuguni the study team, as well Prostitutes Mbuguni the peer educators who supported the recruitment of study participants.

References 1. Consensus statement: supporting safer conception and pregnancy for men And women living with and affected by HIV. AIDS Behav. A systematic review of the current Prostitutes Mbuguni of safer conception strategies for HIV affected heterosexual couples in sub-Saharan Africa.

Munubi leaves the plantation with Saidi and travels to a relative's house in Mombo. Sorrell, J. In their study, ten Brummelhuis and Herdt found. indecent dress popular “among prostitutes, bhang smokers, and wahuni,” and 80 L.A. Mbuguni and G. Ruhumbika, “TANU and National Culture,” in Toward.

Fertility intentions of prenatal and postpartum HIV-positive women in primary care in Mpumalanga province, South Africa: a longitudinal study. View Prostitutes Mbuguni Google Scholar 5.

Factors Prostitutes Mbuguni with desire for children among HIV-infected women and men: a quantitative and qualitative analysis from Malawi and implications for the delivery of safer conception counseling. AIDS Care.

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Fertility desire among HIV-positive women in Tigray region, Ethiopia: implications for the provision of reproductive health and prevention of mother-to-child HIV transmission services.

Prostitutes Mbuguni Womens Health. The Lancet HIV. Lancet HIV. Guideline on safer conception in fertile HIV-infected Prostitutes Mbuguni and couples. View Article Google Scholar World Health Organization.

Consolidated guideline on sexual and reproductive health and rights of women living with HIV. Geneva: World Health Organization; Salamander Trust. Prostitutes Mbuguni a safe house on firm ground: key findings from a global values and preferences survey regarding the sexual and reproductive health and human rights of women living with Prostitutes Mbuguni.

Safer conception interventions for HIV-affected couples: implications for resource-constrained settings. Top Antivir Med. Implementing a pre-exposure prophylaxis intervention for safer conception among HIV serodiscordant couples: recommendations for health care providers.

J Health Prostitutes Mbuguni Res Pract. Study protocol of "Our Choice": a randomized controlled trial of the integration of safer conception counseling to transform HIV family planning services in Uganda. Implement Sci. Prevalence and correlates of use of safer conception methods in a prospective cohort of Ugandan HIV-affected couples with fertility intentions.

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Women were attending services at the invitation of the study team, so they were not necessarily proactively seeking care for a specific concern—whether FP or any other issue—at the time of the consultations. Implementing a pre-exposure prophylaxis intervention for safer conception among HIV serodiscordant couples: recommendations for health care providers. FP counseling for HIV-positive women should be broadened to broach the topic of safer pregnancy, as well as explicit counseling on strategies to minimize risk of sexual transmission to partners.

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