{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:01:42Z","timestamp":1780732902259,"version":"3.54.1"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Centre for International Reproductive Health Training \u2013 The University of Michigan"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Female sex workers (FSWs) in sub-Saharan Africa (SSA) face higher risks of unintended pregnancies and sexually transmitted infections, including HIV. This risk can be reduced with correct and consistent use of dual contraception, defined as the concurrent use of a barrier method together with another modern contraceptive methods. However, there are limited and fragmented data on the prevalence and factors associated with dual contraception use among FSWs in SSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our systematic review and meta-analysis aimed to determine the pooled prevalence of dual contraceptive use and HIV infection prevalence among FSWs in the high HIV-burden settings of SSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources and methods<\/jats:title>\n                    <jats:p>We conducted a comprehensive search of PubMed, MEDLINE, EMBASE, Web of Science, and African Journal Online, from January 1980 up to October 2023. We also reviewed bibliographies of relevant articles to find additional studies. Only observational and interventional studies reporting dual contraceptive use among FSWs in Africa were included, while reviews, case reports, and case series were excluded. Two reviewers evaluated study quality using the modified Newcastle-Ottawa Scale. Data on dual contraceptive use, contraceptives methods, associated factors and HIV prevalence were extracted and analysed using random-effect or fixed-effect meta-analysis models to calculate the pooled prevalence estimates defined as combined average estimates across studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 11 studies, involving a total of 127,059FSWs from eight countries in SSA. HIV prevalence ranged from 1-55% across studies, with a pooled prevalence of 24% (95% confidence interval (CI): 14-35%,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 99.57%, p&lt;0.001). Dual contraception prevalence ranged from 3.8-66.2% across studies, with a pooled prevalence of 26% (95% CI: 12% \u2013 39%,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =99.9%, p&lt;0.001). The most frequently reported contraceptive method were condoms (n=41,200,32.1%) and oral contraceptive pills (n=20,735, 16.5%), followed by injectables (n=6,349, 5.1%), Implants (n=5,430, 4.3%) and intrauterine device (n=601, 0.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dual contraceptive utilization remains sub-optimal among FSWs in SSA, with fewer than one in three FSWs utilising this essential reproductive health strategy. Moreover, HIV prevalence remains high in this population. Targeted strategies to improve utilisation of dual contraception among this marginalised population is needed to reduce the risks of unintended pregnancies, HIV infection and other STIs and their negative impacts on FSWs, their clients, families and the entire healthcare systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057261457908","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:31:26Z","timestamp":1780475486000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual contraceptive use among female sex workers in high HIV-burden settings in sub-saharan Africa: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4515-8517","authenticated-orcid":false,"given":"Felix","family":"Bongomin","sequence":"first","affiliation":[{"name":"Gulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4160-6418","authenticated-orcid":false,"given":"Jerom","family":"Okot","sequence":"additional","affiliation":[{"name":"Gulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Olum","sequence":"additional","affiliation":[{"name":"Makerere University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Madraa","sequence":"additional","affiliation":[{"name":"Ghent University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winnie","family":"Kibone","sequence":"additional","affiliation":[{"name":"Mulago National Referral Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauryn","family":"Nsenga","sequence":"additional","affiliation":[{"name":"Kabale University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethan","family":"Morgan","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Grace","family":"Auma","sequence":"additional","affiliation":[{"name":"Lira University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peninah","family":"Nannono","sequence":"additional","affiliation":[{"name":"Gulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex Male","family":"Kato","sequence":"additional","affiliation":[{"name":"Gulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simple","family":"Ouma","sequence":"additional","affiliation":[{"name":"Gulu University"},{"name":"The AIDS Support Organization"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1205-1150","authenticated-orcid":false,"given":"Pebalo Francis","family":"Pebolo","sequence":"additional","affiliation":[{"name":"Gulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"issue":"3","key":"e_1_3_6_2_2","first-page":"iii18","article-title":"Estimates of the number of female sex workers in different regions of the world","volume":"82","author":"Vandepitte J","year":"2006","unstructured":"Vandepitte J, Lyerla R, Dallabetta G, et al. 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