Evidence map›Paper›PMID 42326018›Full record

ArticleFrontiers in reproductive health2026

A qualitative exploration of menstrual management practices and the impact of menstruation on the livelihoods of female sex workers in a peri-urban area of western Kenya.

Elish McCullough, Garazi Zulaika, Edyth A Osire, Cynthia Akinyi, Fredrick O Otieno, Penelope A Phillips-Howard, Supriya D Mehta, Linda Mason

Abstract read
In one paragraph

Article in Frontiers in reproductive health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Elish McCulloughDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Garazi ZulaikaDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Edyth A OsireNyanza Reproductive Health Society, Kisumu, Kenya.
Cynthia AkinyiNyanza Reproductive Health Society, Kisumu, Kenya.
Fredrick O OtienoNyanza Reproductive Health Society, Kisumu, Kenya.
Penelope A Phillips-HowardDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Supriya D MehtaDivision of Infectious Disease Medicine, Rush University College of Medicine, Chicago, IL, United States.
Linda MasonDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Little is known about female sex worker (FSW) experiences with menstruation and its impact on their economic livelihood and health. To support a future intervention aimed at improving menstrual hygiene management (MHM) for FSW, this study sought to explore FSW's views of MHM, its impact on work, and related practices during client engagement. Methods: This qualitative study conducted seven focus group discussions among 57 FSWs in Kisumu, western Kenya, between June and September 2023. Semi-structured guides assessed current MHM practices, the impact of menstruation on work and livelihood, and clients' perceptions of sex during menses. The data were analysed using thematic analysis. Results: Outside of sex work, FSWs primarily reported using disposable sanitary pads, with tampons, reusable pads, cloths, cotton wool and tissue also reported as methods used to absorb menstrual flow. Many FSWs described continuing sex work during menstruation out of financial necessity. Needing to hide menstrual blood flow when engaging in sex work was customary and women resorted to unsafe practices, including intravaginal cleansing or inserting cotton or tissue high into the vagina to stem bleeding. Most FSWs spoke of losing income during their menses from stopping work entirely or reducing the number of clients seen. Women reported a range of client attitudes towards sex during menstruation, from indifference to disgust, with most reporting negative views. FSWs discussed that clients frequently refused services if they became aware of menstruation and that non-payment or physical abuse from clients could occur upon discovering menstruation. Conclusions: The use of harmful practices to conceal menstrual blood during sex work underscores a critical need for safer menstrual management solutions for this population that can be used discreetly and comfortably during sex, such as menstrual discs that can be worn during sex. Negative perceptions of menstruation contribute to increased financial instability in this population.

Indexed as

economic livelihoodfemale sex workersintravaginal practicesKenyamale clientsmenstrual cupmenstrual hygienemenstruation

Identifiers

PMID42326018
PMCPMC13279765

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.