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Background: Street women are women, who make their living on the streets by begging, sleeping in the streets, or on the sides of roads. They are the most marginalized and neglected segment of society, with little access to health care, including modern contraception, and a lack of knowledge about health services, particularly in Ethiopia. Therefore, this study aimed to examine modern contraceptive utilization and associated factors among street women. Methods: A systematic review and meta-analysis were conducted on observational community-based studies published from January 2010 up to February 1, 2023. PubMed, Google Scholar, HINAR, Scopus, Web of Sciences, and grey literature were used to search primary studies. We used Microsoft Excel for data entry and extracting data. STATA-17 statistical software was used to analyze the data as well and I2 tests evaluated study heterogeneity. The pooled utilization of the modern contraceptive method was predicted using a random-effect model. Results: A total of eight studies were included. The pooled prevalence of modern contraceptive utilization was 51.89% (95% CI: 40.89–62.9). Being married (OR = 4.22, 95%CI, 2.75–6.49); facing a history of sexual assault/rape at a street life (OR = 3.59, 95%CI, 2.46–5.23); age between 25–35 years (OR = 3.27, 95%CI, 1.73–6.18), getting advise from the health professionals (OR = 6.23, 95%CI, 1.44–27.07), having a history of pregnancy in street life (OR = 1.90, 95%CI, 1.28–2.81) and no more children wanted (OR = 2.47, 95%CI, 1.52–5.00) were significantly associated with modern contraceptive utilization. Conclusions: The pooled modern contraceptive utilization was suboptimal. Every concerned body or stakeholder should give more consideration to their lifestyles and living conditions by raising awareness and providing access to contraception. [ABSTRACT FROM AUTHOR]

Introduction: Transactional sex is casual sex between two people to receive material incentives in exchange for sexual favors. Transactional sex is associated with negative consequences, which increase the risk of sexually transmitted diseases, including HIV/AIDS, unintended pregnancy, unsafe abortion, and physiological trauma. In Sub-Saharan Africa, several primary studies have been conducted in various countries to examine the prevalence and associated factors of transactional sex among women. These studies had great discrepancies and inconsistent results. Hence, this systematic review and meta-analysis aimed to synthesize the pooled prevalence of the practice of transactional sex among women and its associated factors in Sub-Saharan Africa. Method: Data source: PubMed, Google Scholar, HINARI, the Cochrane Library, and grey literature were searched from March 6 to April 24, 2022, and included studies conducted from 2000 to 2022. The pooled prevalence of transactional sex and associated factors was estimated using Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic, a funnel plot, and Egger's test were used to check for heterogeneity and publication bias, respectively. A subgroup analysis was done based on the study years, source of data, sample sizes, and geographical location. Results: The pooled prevalence of transactional sex among women in Sub-Saharan Africa was 12.55% (9.59%–15.52%). Early sexual debut (OR = 2.58, 95% CI: 1.56, 4.27), substance abuse (OR = 4.62, 95% CI: 2.62, 8.08), history of sexual experience (OR = 4.87, 95% CI: 2.37, 10.02), physical violence abuse (OR = 6.70, 95% CI: 3.32, 13.53), orphanhood (OR = 2.10, 95% CI: 1.27, 3.47), and sexual violence abuse (OR = 3.76, 95% CI: 1.08, 13.05) were significantly associated with transactional sex. Conclusion: The prevalence of transactional sex among women in sub-Saharan Africa was high. Alcohol consumption, substance abuse, early sex debuts, having a history of sexual experiences, physical violence, and sexual violence increased the practice of transactional sex. [ABSTRACT FROM AUTHOR]