sexual coercion, hiv risk behavior and sexual health among female waitresses in jimma town, south west Ethiopia

Abstract

Background: - Globally at least one in three women has been sexually coerced in her lifetime. Sexual coercion has been shown to be associated with a number of risky behaviors that in turn may also have adverse health consequences. Sexual behaviors are the primarily mode of HIV transmission. There is little sero-prevalence signifying risk of waitresses for HIV/AIDS and the link between sexual coercion and HIV risk behavior has not been documented in numerous studies across the region in Ethiopia. Thus, this study aimed to assess the association between Experience of Sexual coercion, HIV risk behavior and sexual health among female waitresses in Jimma town, southwest Ethiopia. Methods:-A cross-sectional study design was employed from April 1, to 30, 2018 on 422 female waitresses of age 15-49 working in the licensed food and drinking establishments in Jimma town. A sampling frame containing the list of all licensed food and drinking establishments in Jimma town was used and 30% of the total establishment was selected by using lottery method. Structured interviewer administered questionnaire was used for data collection. Data was entered to EPI data version 3.1 and then exported to SPSS version 21 for analysis. Bivariate analysis was made and those Variables with P-value (<0.25) were subjected to multivariate analysis. Interpretation of the association was made in-terms of adjusted odds ratio with 95% confidence interval. Result: - The life time experience of sexual coercion among female waitresses was 71.4% and about 71.6% of females reported to have HIV risk behavior. Female waitresses who were working in bar were 4.6 times more likely to engage in HIV risk behavior (AOR 4.64, 95% CI: 2.15-10.0), females who were ever used substance were three times more likely to engage in HIV risk behavior (AOR 3.37, 95% CI: 1.7-6.7) than non substance users. Those who experienced sexual coercion in the last 12month have 3.6 times more likely to have HIV risk behavior (AOR 3.6, 95% CI: 2.02-6.74) than those not experienced sexual coercion in the last 12months. The experiences of sexual coercion have a stronger association with HIV risk behavior (AOR 7.6, 95% CI: 3.8-15.3) than those not experienced sexual coercion after adjusting for the potential confounders (workplace, age and substance use) in multi-logistic regression analysis. Conclusion: - A significant number of female waitresses were engaged in HIV risk behaviors notably high engagement in multiple sexual partner, concurrent sex, alcohol or substance use before sex and low consistency of condom use and were prone to unwanted pregnancy, abortion and STD. workplace, age, substance use and sexual coercion were the major predictors of HIV risk behavior. Therefore, establishments, Town health office and other stakeholders should be involved in protecting the female waitresses from the burden of sexual coercion, HIV risk behavior and sexual ill-health.