Factors associated with induced abortion among female entertainment workers: a cross-sectional study in Cambodia

Objective: To explore risk factors associated with induced abortion among sexually active female entertainment workers (FEWs) in Cambodia. Design: Cross-sectional study. Setting: Phnom Penh and Siem Reap, Cambodia. Participants: This study included 556 FEWs aged 18-47 years randomly selected from entertainment establishments in the two cities in 2014 using a two-stage cluster sampling method. Data were collected through face-to-face interviews using a structured questionnaire. Primary outcome measure: History of induced abortion during the time working as a FEW. Results: Of the total sample, 45.6% reported currently using a contraceptive method with condom (42.4%) being the most common method, followed by pills (25.6%). One-fourth (25%) of the respondents reported having been pregnant at least once, and 21.4% reported having at least one induced abortion during the time working as a FEW. After controlling for other covariates in a multivariate logistic regression model, FEWs with a history of induced abortion remained significantly more likely to be currently working in a karaoke bar (AOR= 1.75, 95% CI 1.10 to 2.78), to have worked longer as a FEW (AOR= 1.42, 95% CI 1.06 to 1.43), to have had a greater number of sexual partners in the past 12 months (AOR= 1.86, 95% CI 1.02 to 1.54), to be currently using a contraceptive method (AOR= 1.52, 95% CI 1.01 to 2.29), to be able to find condoms when they needed them (AOR= 2.03, 95% CI 1.09 to 3.82), and to report inconsistent condom use with non-commercial partners in the past 3 months (AOR= 1.62, 95% CI 1.06 to 3.44). Conclusions: This study highlights the high rates of unwanted pregnancies that ended in induced abortions among FEWs in Cambodia. Access of FEWs to quality sexual and reproductive healthcare services is deemed a high priority. Integrated interventions to improve sexual and reproductive health among these vulnerable women should be tailored to reach the most-at-risk groups.