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Introduction <p>Sri Lanka’s highly restrictive abortion law may shape abortion legitimacy and stigma. Female sex workers (FSWs) warrant specific attention because reproductive decision-making may be shaped by occupational stigma, criminalisation, violence, and barriers to sexual and reproductive health (SRH) care. General-population evidence may therefore not adequately represent the perspectives of this marginalised group. This study examined abortion-law attitudes among Colombo FSWs, with contextual comparisons to women from the general population and female factory workers (FFWs).</p> Methods <p>A cross-sectional respondent-driven sampling survey was conducted among Colombo FSWs from March to June 2025 (<i>n</i> = 551). Attitudes were measured using a validated eight-item scale assessing support for abortion legalisation under specific indications; scores of 31–40 were classified as liberal. Associations were examined using logistic regression. Item-level endorsement was compared with women from the general population and FFWs.</p> Results <p>Among Colombo FSWs, the RDS-weighted prevalence of liberal abortion-law attitudes was 37.5% (95% CI 33.26–41.61). Support was highest for threats to life, rape, incest, and fetal abnormalities, and lower for socio-economic or request-based indications. Television exposure and work typology were associated with liberal attitudes. FSWs showed higher endorsement than both comparator groups across several specific indications, suggesting that their attitudes are not simply a mirror of broader female population views.</p> Conclusions <p>Abortion-law attitudes among Colombo FSWs were heterogeneous. FSWs showed higher endorsement of abortion legalisation across several specific indications compared with women from the general population and FFWs.</p> Policy Implications <p>Abortion-law and SRH policy discussions in restrictive settings should consider indication-specific attitudes and include marginalised populations whose reproductive experiences may differ from those of other women.</p>

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Abortion-law Attitudes and Correlates Among Female Sex Workers in Colombo: A Cross-sectional Community-based Study with Contextual Comparisons to Other Female Populations

  • 期刊论文

  • 发表日期：

    2026年8月4日

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  • M. Suchira S Suranga,
  • Karunathilake Kankanige,
  • W. Indralal De Silva

摘要

Introduction

Sri Lanka’s highly restrictive abortion law may shape abortion legitimacy and stigma. Female sex workers (FSWs) warrant specific attention because reproductive decision-making may be shaped by occupational stigma, criminalisation, violence, and barriers to sexual and reproductive health (SRH) care. General-population evidence may therefore not adequately represent the perspectives of this marginalised group. This study examined abortion-law attitudes among Colombo FSWs, with contextual comparisons to women from the general population and female factory workers (FFWs).

Methods

A cross-sectional respondent-driven sampling survey was conducted among Colombo FSWs from March to June 2025 (n = 551). Attitudes were measured using a validated eight-item scale assessing support for abortion legalisation under specific indications; scores of 31–40 were classified as liberal. Associations were examined using logistic regression. Item-level endorsement was compared with women from the general population and FFWs.

Results

Among Colombo FSWs, the RDS-weighted prevalence of liberal abortion-law attitudes was 37.5% (95% CI 33.26–41.61). Support was highest for threats to life, rape, incest, and fetal abnormalities, and lower for socio-economic or request-based indications. Television exposure and work typology were associated with liberal attitudes. FSWs showed higher endorsement than both comparator groups across several specific indications, suggesting that their attitudes are not simply a mirror of broader female population views.

Conclusions

Abortion-law attitudes among Colombo FSWs were heterogeneous. FSWs showed higher endorsement of abortion legalisation across several specific indications compared with women from the general population and FFWs.

Policy Implications

Abortion-law and SRH policy discussions in restrictive settings should consider indication-specific attitudes and include marginalised populations whose reproductive experiences may differ from those of other women.