Multifactorial drivers of engagement in sex work among Ethiopian women: a multinomial logistic regression approach

BackgroundUnderstanding the multifactorial drivers of female sex workers' (FSWs) engagement in Ethiopia is essential for designing effective public health interventions. While economic drivers are often emphasized, the roles of family, social, and geographic contexts remain underexplored.Method...

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Main Authors: Dawit Sekata Duressa, Lemessa Negeri Debel, Saro Abdella Abrahim
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Global Women's Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fgwh.2025.1512560/full
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author Dawit Sekata Duressa
Lemessa Negeri Debel
Saro Abdella Abrahim
author_facet Dawit Sekata Duressa
Lemessa Negeri Debel
Saro Abdella Abrahim
author_sort Dawit Sekata Duressa
collection DOAJ
description BackgroundUnderstanding the multifactorial drivers of female sex workers' (FSWs) engagement in Ethiopia is essential for designing effective public health interventions. While economic drivers are often emphasized, the roles of family, social, and geographic contexts remain underexplored.MethodsWe analyzed data from a cross-sectional bio-behavioral survey of 6,085 FSWs across 16 Ethiopian urban centers conducted from December 2019 to April 2020. Multinomial logistic regression was used to assess associations between primary motivations for engaging in sex work—categorized as economic, family-related, combined economic-family, or social/behavioral—and socio-demographic, behavioral, and health-related factors.ResultsEconomic reasons were most common (41.7%), followed by family-related (22.7%), combined economic-family (21.0%), and social/behavioral (14.6%) motivations. Geographic variation was evident: FSWs in Addis Ababa, the capital in central Ethiopia, had lower odds of reporting family-related reasons (AOR = 0.52) than those in Adama, another central commercial city. FSWs in Dessie–Kombolcha, in northeastern Ethiopia, were more likely to report social or behavioral motivations (AOR = 2.02). Age, education, marital status, income, and healthcare access were also significant predictors. Women aged 35–59 were less likely to cite family (AOR = 0.50) or social motivations (AOR = 0.55), while those with secondary education were more likely to report family-related reasons (AOR = 1.54). Limited healthcare access and early initiation into sex work were associated with non-economic drivers.ConclusionFSWs' engagement is influenced by intersecting economic, familial, and geographic factors. Tailored interventions should consider age, location, and service accessibility. The cross-sectional design limits causal interpretation.
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spelling doaj-art-8223f203b1204ffbb7dd79bfab0824d72025-08-20T02:37:06ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592025-07-01610.3389/fgwh.2025.15125601512560Multifactorial drivers of engagement in sex work among Ethiopian women: a multinomial logistic regression approachDawit Sekata DuressaLemessa Negeri DebelSaro Abdella AbrahimBackgroundUnderstanding the multifactorial drivers of female sex workers' (FSWs) engagement in Ethiopia is essential for designing effective public health interventions. While economic drivers are often emphasized, the roles of family, social, and geographic contexts remain underexplored.MethodsWe analyzed data from a cross-sectional bio-behavioral survey of 6,085 FSWs across 16 Ethiopian urban centers conducted from December 2019 to April 2020. Multinomial logistic regression was used to assess associations between primary motivations for engaging in sex work—categorized as economic, family-related, combined economic-family, or social/behavioral—and socio-demographic, behavioral, and health-related factors.ResultsEconomic reasons were most common (41.7%), followed by family-related (22.7%), combined economic-family (21.0%), and social/behavioral (14.6%) motivations. Geographic variation was evident: FSWs in Addis Ababa, the capital in central Ethiopia, had lower odds of reporting family-related reasons (AOR = 0.52) than those in Adama, another central commercial city. FSWs in Dessie–Kombolcha, in northeastern Ethiopia, were more likely to report social or behavioral motivations (AOR = 2.02). Age, education, marital status, income, and healthcare access were also significant predictors. Women aged 35–59 were less likely to cite family (AOR = 0.50) or social motivations (AOR = 0.55), while those with secondary education were more likely to report family-related reasons (AOR = 1.54). Limited healthcare access and early initiation into sex work were associated with non-economic drivers.ConclusionFSWs' engagement is influenced by intersecting economic, familial, and geographic factors. Tailored interventions should consider age, location, and service accessibility. The cross-sectional design limits causal interpretation.https://www.frontiersin.org/articles/10.3389/fgwh.2025.1512560/fullfemale sex workersmultinomial logistic regressionHIV vulnerabilitypublic health interventionurban sex workcross-sectional study
spellingShingle Dawit Sekata Duressa
Lemessa Negeri Debel
Saro Abdella Abrahim
Multifactorial drivers of engagement in sex work among Ethiopian women: a multinomial logistic regression approach
Frontiers in Global Women's Health
female sex workers
multinomial logistic regression
HIV vulnerability
public health intervention
urban sex work
cross-sectional study
title Multifactorial drivers of engagement in sex work among Ethiopian women: a multinomial logistic regression approach
title_full Multifactorial drivers of engagement in sex work among Ethiopian women: a multinomial logistic regression approach
title_fullStr Multifactorial drivers of engagement in sex work among Ethiopian women: a multinomial logistic regression approach
title_full_unstemmed Multifactorial drivers of engagement in sex work among Ethiopian women: a multinomial logistic regression approach
title_short Multifactorial drivers of engagement in sex work among Ethiopian women: a multinomial logistic regression approach
title_sort multifactorial drivers of engagement in sex work among ethiopian women a multinomial logistic regression approach
topic female sex workers
multinomial logistic regression
HIV vulnerability
public health intervention
urban sex work
cross-sectional study
url https://www.frontiersin.org/articles/10.3389/fgwh.2025.1512560/full
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