Ethics approval and consent to participate
Each participant provided written informed consent prior to the interview and no nominal information was reported on the questionnaire. The study was approved by the ethics committee of the CHU de Québec – Université Laval (Québec, Canada) and by the National Health Research Ethics Committee in Benin.
Consent for publication
Not applicable
Availability of data and materials
The datasets used and analysed during the current study are available from the corresponding author an reasonable request.
Competing interests
The authors declare that they have no competing interests.
Funding
This study was funded by the Canadian Institutes of Health Research (grants # ROH-115205 and # FDN-143218). The funder did not play any role in conducting the research or writing the paper.
Authors’ contributions
MA, FAG, LA, EB, MPG, DMZ and AK designed the study. FAG, GB, FK, and LB collected the data. GPS analyzed and interpreted the data regarding the three objectives of this article. MA supervised closely all the steps leading to the production of this article and was the principal investigator on the grant that supported the study financially. FAG, GB, LA, EB and MPG revised the manuscript for important intellectual content. All authors read and approved the final manuscript and accept responsibility for the integrity of the data analysis. As for being accountable for all aspects of the work in ensuring that questions related to the accuracy or the integrity of any part of the work are appropriately investigated and resolved.
Acknowledgements
The authors thank the study participants and the interviewers for their contribution to the study.
Authors’ information
Gentiane Perrault Sullivan, MSc., Psy. Ed.: Madame Perrault Sullivan is a PhD. Student in epidemiology at Université Laval. Her primary research interest is the reproductive health of vulnerable populations. She specializes in pregnancy outcomes, pregnancy intention and the prevention of unintended pregnancy.
Fernand A. Guédou, MD, MSc, Dip. GUM, PhD is a medical doctor, microbiologist and epidemiologist and specialized in genito-urinary medicine. He is researcher at the Dispensaire IST in Cotonou, Benin and coordinating the research progam POCAO. His research interests are STI/HIV prevention and reproductive health.
Georges Batona, MSc, PhD is a specialist in program planning and evaluation. A graduate of Laval University, Quebec Canada, he is a research assistant and program officer at the Dispensaire IST in Cotonou, Benin. His research interests are HIV/AIDS prevention, reproductive health, health promotion, participatory research.
Frédéric Kintin is a Beninese doctor, graduate of a master's degree in tropical biomedical sciences. He has been an independent consultant since 1996. He has coordinated several HIV/AIDS projects/programs and carried out missions to evaluate health promotion projects among vulnerable populations.
Luc Béhanzin is a medical doctor, Community health specialist and epidemiologist. He specialized in major epidemics (HIV, viral hemorrhagic fevers, etc.). He is a researcher at Dispensaire IST in Cotonou, and a research associate at University of Parakou in Benin.
Lisa Avery BSc, MIH, MD, is an obstetrician and gynecologist and an assistant professor at the University of Manitoba’s Centre for Global Public Health. Her primary research interest is the sexual and reproductive health and rights of marginalized populations globally.
Emmanuelle Bédard, Mps, Ph.D., is professor in Nursing sciences at Université du Québec à Rimouski. She works in health promotion with different populations who live in vulnerable context especially female sex workers in West Africa and Canada.
Marie-Pierre Gagnon is Full Professor, Faculty of Nursing, Laval University, and researcher, Quebec University Hospital Research Centre. She is Tier 2 Canada Research Chair in Technologies and Practices in Health. Her research focuses on patient involvement and innovations in healthcare.
Djimon Marcel Zannou is an internal medicine specialist at the Centre national universitaire HMK. He is also professor of medicine and vice-rector of academic affairs at University of Abomey-Calavi, Cotonou, Benin. He oversees the main HIV clinic in Benin.
Adolphe Codjo Kpatchavi is a full professor in health anthropology at the University of Abomey-Calavi, Benin. He is also the scientific director of the Laboratoire d’anthropologie médicale appliquée. His research focuses on access to care, health politics and systems and HIV-AIDS.
Michel Alary is a medical epidemiologist and Professor of epidemiology, Faculty of Medicine, Université Laval. He has devoted most of his career to epidemiologic and prevention research among the most vulnerable populations in the field of HIV/STIs and reproductive health.