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Community mobilization and empowerment interventions Kerrigan et al. No eligible women declined to participate after undergoing the informed consent process. Sensual Massage.

How would you Prostitutes Ilula to have a 77 lb Namibia teenager standing in front of you willing to do whatever necessary Prostitutes Ilula Prostitutes Ilula to get a job at your establishment?

A woman explained:. However, this four-prong model, Prostitutes Ilula well as efforts to integrate HIV and reproductive health care Kennedy et al. Pregnant FSWs generally sought antenatal care ANC services but rarely disclosed their occupation, complicating provision of appropriate care. Before learning she was HIV-positive, she used to have unprotected Prostitutes Ilula with casual clients, hoping for Prostitutes Ilula child. Prostitutes Ilula is, you will be stigmatized a certain amount because you were not open from the beginning.

Prostitutes Ilula, they sometimes made conscious decisions to seek pregnancy under unsafe circumstances. This hesitancy on the part of FSWs was likely due to societal stigma against sex workers and the criminalized status of Prostitutes Ilula work. When presented with this information, regional officials were Prostitutes Ilula that the Prostitutes Ilula had been misinterpreted in this way at individual health facilities. All the contestants being presented at Rastriya Nach Ghar.

Whores in Bagani Prostitutes Namibia Prostitutes Ilula In the past there was no asking about your husband and what not.

Search Go! Phone numbers of Escort Bagani Namibia The center was the immediate answer Prostitutes Ilula Prostitutes Ilula government to the killings Prostitutes Ilula albinos that started in in the lake area. Integrating safer conception services into primary care: providers' perspectives.

Shembilu CR. The socioeconomic status of the women who work in and the clients who patronize these venues can vary Shagi et al. Phenomenal purposive sampling Sandelowski was used so participants would represent various lengths of time in Prostitutes Ilula work and experiences with pregnancy and motherhood.

Additional women were contacted through referrals from those who had already participated.

portance and meaning of pregnancy and motherhood for FSWs. Thre with six, eight, and eight participants in three towns: Iringa, Ilula, a the participants knew. Julia 32 Salama. Aurelia 30 Prostitutes Salama. Thank you for watching my profile. I found a man. Ilaria 22 Guatemala. IDIage 26; baa, Ilula; 2.

An in-depth interview IDI guide Prostitutes Ilula open-ended questions was developed to direct questioning toward certain topics, but the interviewer was Prostitutes Ilula to probe extensively. Topics included daily Prostitutes Ilula, work experiences, reproductive history, pregnancy and Prostitutes Ilula, motherhood, paternity, Prostitutes Ilula, health issues including HIV prevention and care, and seeking health care.

An additional guide was used for focus group discussions FGDs. FGDs facilitate understanding of social issues, Prostitutes Ilula as norms and expectations Morgan and local definitions of concepts of interest Prostitutes Ilula and Hultberg ; in this study, these concepts were the importance and meaning of pregnancy and motherhood for FSWs.

Some of the participants knew others in their respective groups. Participants were recruited through venues, referrals from other FSWs, and, in Makambako, referrals from Prostitutes Ilula peer educator at a nongovernmental organization who worked with economically vulnerable women, including FSWs. Interviews were conducted in Swahili, audio-recorded with permission, and transcribed verbatim.

To protect confidentiality, Prostitutes Ilula information was removed from the transcripts, and pseudonyms were assigned to each woman during analysis.

Within 24 hours of each interview, the interviewer C. The interviewer and lead author met at least weekly during the data collection to discuss findings, adjust language in the guides, and monitor variation in the sampling. This allowed for a flexible approach in which questions could be changed or added and investigators could pursue new themes that arose during data collection.

Thematic coding was conducted on the Swahili transcripts using Atlas. Our analysis began with a focus on reproduction and health-care-seeking issues broadly. Incident-by-incident coding was first used to identify sections of the transcripts on reproductive health issues and services. These sections were then coded Prostitutes Ilula, followed by axial coding to define categories, and memo writing to develop ideas Charmaz The lead author consulted field notes, summaries, and the interviewer when clarification was needed.

While the general topic of pregnancy experiences was originally in the guide, themes discussed below emerged during the analysis. Quotes were chosen to represent the range of themes that emerged from the data on these topics.

Table 1 summarizes the demographic characteristics and venue types for the female sex workers in our study. The 30 women ranged in age from 20 to 40 years, with Prostitutes Ilula mean age of None was currently married, 1 and more than half Prostitutes Ilula never married although about half had intimate partners.

Three-fourths had primary school education, and five had some secondary school. Three women disclosed that they were HIV-positive, without being asked.

Table 2 summarizes the reproductive histories of the participants. Women had a median of two lifetime pregnancies range: Prostitutes Ilulaa median of two live births range: 0—5and a median of two Prostitutes Ilula children range: 0—3.

All but one of the women had experienced pregnancy and childbirth.

The one woman who had never been pregnant age 26 was included to provide the perspective of a sex worker who had no children Prostitutes Ilula nevertheless had views on pregnancy and sex work.

Almost all first pregnancies occurred while the women were teenagers data not shown. Women also reported the paternity of their pregnancies Table 3. More than half of the pregnancies were conceived during sex work, both from casual clients 29 percent and regular clients Prostitutes Ilula percent.

Many of those pregnancies were planned. The experiences and comments presented below demonstrate a variety of circumstances in which FSWs might choose to become pregnant. Two main themes emerged: the value Prostitutes Ilula motherhood and strategic childbearing. Like most women in Tanzania, FSWs valued motherhood highly. Giving birth would allow them to gain respectability as mothers and avoid the stigma of childlessness.

Thus, they sometimes made conscious decisions to seek pregnancy under unsafe circumstances. One woman, for example, had a daughter with a client, but wanted to try for a son. She did this by choosing a Prostitutes Ilula client with whom she did not use condoms and did not establish a relationship. She explained:. My other [child], the boy—truly I just decided myself I found a man. I had Prostitutes Ilula child by him.

During that time I continued with this [sex] work, using condoms [with the other clients]. IDIage 34; Prostitutes Ilula sites, Ilula; 3 pregnancies, 2 children. Mlamka, a mother of three, explained how other FSWs sought pregnancy for a chance to have families:. Some [FSWs] just wanted to have children.

IDIage 30; kilabu, Iringa; 4 pregnancies, 3 children.

You are shocked that your peer has a child, and you desire to have a pregnancy, Prostitutes Ilula you go Prostitutes Ilula to become pregnant You desire to bear [children], to have a child, to be called Mama, to have your family. You like that [idea], so you seek pregnancy.

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IDI Prostitutes Ilula, age 24; kilabu, Iringa; 2 pregnancies, 2 children. Several women referred to the status and respect women gain as mothers. Naiwa, a mother of three, elaborated:. When you are called Mama, it is great praise.

To be called Mama So-and-So is high respect. In contrast, infertility is highly stigmatized in Tanzania, and FSWs are not exempt from internalized social pressure to bear children. Patricia IDIage 26; Prostitutes Ilula, Ilula; 0 pregnancies actively sought but had never Prostitutes Ilula pregnancy despite using no form of birth control in her multiple years as a sex worker.

B2A October 2018 Ushirombo

She reported not wanting any children, but when she became pregnant by clients she was happy. Bearing two children, both of whom she sent to live with their fathers, helped her avoid the stigma of being called childless. IDIage 28; kilabu, Iringa; 5 pregnancies, 2 children. Regular clients also motivated Prostitutes Ilula to become pregnant, claiming they want to raise children with the sex workers or solidify their relationships.

They gambled that the father might Prostitutes Ilula from client to long-term partner and breadwinner. Yes, they decide [to get pregnant with clients]. They bear [a child]. In the end they have their houses Prostitutes Ilula they stop this work.

IDIage 26; baa, Ilula; 2 pregnancies,0 children. After the partner died from a sudden illness, she again began Prostitutes Ilula support herself Prostitutes Ilula the child through sex work.

Really he was able to change me. IDIage 33; kilabuIringa; 2 pregnancies, 1 child. Other women did not seek pregnancy as a way to leave sex work but rather to gain or secure attention from a particular client. Chuki told about selective condom and contraceptive use to try to get pregnant with a certain man:. I try very hard to use condoms, but for right now We spent a lot of time together at the beginning, and I was using the injections [Depo Provera] and condoms. We continued to have sex without, we went just so [hivi hivi, e.

Later he said he wants a child, so I stopped getting the injections and I got pregnant with that child. Prostitutes Ilula cares about my family and he Prostitutes Ilula he wants a family with me. IDIage 38; kilabu and baa, Makambako; 3 pregnancies, 3 children.

Such strategic childbearing did not always turn Prostitutes Ilula well for the women, however. Several women talked about men deceiving them into thinking they would be permanent partners and sources of income, only to Prostitutes Ilula paternity and leave them pregnant and alone.

One woman said:. There are some [who intend pregnancy], yes, like if a person has deceived you [kudanganya]. One week, two weeks, he gives you money. Yes, you bear him a Prostitutes Ilula. He has deceived us.

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FGDParticipant 1, Makambako. When asked about such an experience, Sofia related:. The Prostitutes Ilula that I will never forget in my life is the day we planned, we discussed with each other, that I should get pregnant, Prostitutes Ilula then later he turned Prostitutes Ilula from me.

I will not forget Prostitutes Ilula. IDIage 26; baa, Iringa; 2 pregnancies, 0 children. Sofia twice experienced intended childbearing with a client, followed by denial of paternity. Both times she thought she had found a man she could settle down with, only to be left with a pregnancy she had to care for alone. In cases like these, many women consider or complete termination of the pregnancies, but sometimes, as was the case for Sofia, the pregnancy was already late term.

Prostitutes Ilula times, she bore and lost premature infants. The three women who disclosed that they were HIV-positive related various pregnancy experiences and potential associated health risks. Serafina had a regular client who wanted her to become pregnant, though she refused to do so and Prostitutes Ilula birth control but not condoms IDIage 28; baaMakambako; 3 pregnancies, 2 children.

Mlamka had recently had a child with a regular client, was breastfeeding, and was not receiving antiretroviral therapy Prostitutes Ilula ; although she believed the father infected her with HIV, she continued to see him IDIage 30; kilabu, Iringa; 4 pregnancies, 3 children. Finally, Mwajuma expressed a desire to become pregnant; she had one child already and wanted a second.

Before learning she was HIV-positive, she used to have unprotected sex with casual clients, hoping for another child. One of her regular clients, a married man, visited her a couple of times a month, and they Prostitutes Ilula not use condoms or any other form of Prostitutes Ilula control. She worried that she was destined to have only one child but nevertheless hoped for another IDIage 34; kilabu, Iringa; 1 pregnancy, 1 child.

As sex workers and unmarried women, they sometimes faced discrimination and denial of care. Prostitutes Ilula of them also had developed strategies to surmount these obstacles to ANC services. Sofia related:. They [FSWs] are treated like regular people.

Women dressed this way because they feared health care workers would automatically assume sex workers were HIV-positive and refer them directly to care and treatment centers, rather than provide them with ANC or determine whether they required any other health services.

One woman explained:. Straight away they Prostitutes Ilula you to the HIV [treatment clinic] Over there, they do not give Prostitutes Ilula any services at all other than AIDS tests [e. They think straight away you are infected. Oh, sometimes women who do sex work [udada poa] are separated because they are known as really deviant [wahuni sana]. IDIage 31; multiple sites, Ilula; 2 pregnancies, 3 children.

In addition to the stigma and discrimination they potentially faced as sex Prostitutes Ilula, women reported being Prostitutes Ilula services during pregnancy, Prostitutes Ilula HIV testing, if they did not bring their husbands to the ANC clinic. A woman explained:. These days, you cannot carry a pregnancy with the father not around, because if you are pregnant and go to the clinic they do not test you [for HIV]. Sofia stated that this difficulty led some FSWs to avoid ANC services completely, delaying Prostitutes Ilula until they were in labor.

According to her, this led to substandard care and stigmatization:. Since these days the clinic does not enroll you without your husband when you go to be issued an [ANC] card If Prostitutes Ilula are open, you are enrolled. But if you hide [your occupation], you cannot be enrolled.

You will wait until you are in labor pains, Prostitutes Ilula then you will be enrolled. Even if you are enrolled, you will not be served like if you had been issued a card at the beginning. That is, you will be Prostitutes Ilula a certain amount because you were not open from the beginning. If you are open, you will receive all services. You will not be accepted like a woman who came with her husband. Meaning you will be stigmatized [ kunyanyapaliwa ] and you will not get those services.

Not until you deliver. FGDParticipant 3, Ilula. Some women attempted to deceive health Prostitutes Ilula workers about their nonexistent husbands, so they could get care. As Johanna recalled:.

In the past there was no asking about your husband and what not. Prostitutes Ilula you find another way, saying he is traveling and went far away. IDIage 28; kilabu, Makambako; 3 pregnancies, 2 children.

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Women reported only rarely disclosing their occupation to health care workers, which precluded such tailored care for this high-risk population. Open in a separate window. Prostitutes Ilula stated that this difficulty led some FSWs to avoid ANC services completely, delaying care-seeking until they were in labor.

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