Factors Affecting Routine Healthcare Check-Ups by Female Sex Workers in Bangladesh

Background: The health vulnerabilities faced by female sex workers in developing countries are distinct. Regular health checkups can play a crucial role in preventing the transmission of infectious diseases through early detection, thereby safeguarding the workers from prolonged periods of illness. Therefore, our study aims to identify the factors afecting routine healthcare check-ups by female sex workers in Bangladesh.

Methods: A total of 384 female sex workers were recruited for participation in this cross-sectional research. A purposive sampling method was employed, and a structured interview schedule, guided by the researchers, was utilized to survey the participants. The investigation investigated both bivariate and multivariate analyses to discern the factors linked to the routine health check-up behaviors among female sex workers.

Results: Around two-thirds (64.1%) of the female sex workers reported going for a routine health check-up at least once in the last 6 months. Participants from larger families exhibited markedly increased odds of experiencing this outcome, with those having fve or more family members being 3.67 times more likely to do so (AOR = 3.67, 95% CI 1.47–9.19). A higher income signifcantly decreased the likelihood of attending a routine health check, with progressively lower odds observed across increasing income categories (AOR = 0.33, 95% CI 0.13–0.85; AOR = 0.15, 95% CI 0.06–0.42; AOR = 0.06, 95% CI 0.02–0.20). Residential-based sex workers exhibited lower odds of reporting the outcome (AOR = 0.21, 95% CI 0.09–0.52). Additionally, participants with a higher number of clients per day showed increased odds of attending routine health check-ups, with those serving fve or more clients per day being 3.96 times more likely to do so (AOR = 3.96, 95% CI 1.40–11.24). Other variables, including age, district, religion, age of initiation into sex work, experiences of abuse, and condom use frequency, were not found to be statistically signifcant in the adjusted model.

Conclusion: The health vulnerabilities faced by female sex workers in Bangladesh arise from a complex interplay of sociodemographic and structural factors, such as family size, income levels, nature of sex work, and client load. Improving fnancial capacity and awareness is essential for advancing their access to health services. Eforts at the policy level that concentrate on economic disparities, enhancing access to targeted interventions, and addressing structural barriers are essential for protecting health rights and fostering overall physical and mental health well-being.