Actions taken by female sex workers (FSWs) after condom failure in semi urban Blantyre, Malawi

Donatien Twizelimana,Adamson S Muula

doi:10.1186/s12905-020-01142-y

Donatien Twizelimana, Adamson S Muula

Open Access

https://doi.org/10.1186/s12905-020-01142-y

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Abstract

BackgroundLittle is known about actions taken by female sex workers (FSWs) after male condom failure during male–female sexual intercourse. The objective of this study was to investigate the actions taken by FSWs after condom failure among FSWs in semi-urban, Blantyre in Malawi.MethodsA cross sectional, qualitative study was conducted among FSWs in Blantyre, Malawi between May and July 2019. Snowballing technique was used to recruit study participants in four purposively selected study sites. Focus group discussions and in-depth interviews were conducted by trained research assistants among 40 FSWs. Data were analyzed using thematic content analysis.ResultsStudy participants reported having taken different actions after condom failure. Out of 18 FSWs who experienced condom failure, 10 reported to have stopped sex immediately and changed the condom and then resumed afterwards. They reported to have douched, urinated, and/or squatted to prevent pregnancy, sexually transmitted infections (STIs) and HIV acquisition. Five study participants reported to have asked for extra pay from the client; 10 FSWs didn’t seek medical care. They thought the actions taken were enough for HIV and pregnancy prevention. Out of the 18 FSWs, only 3 stopped sexual intercourse completely and sought medical care which included post-exposure prophylaxis for HIV, STI treatment, and emergency contraceptives. Another 3 reported that they did not stop the sexual intercourse but only squatted and/or douched after sexual intercourse. The remaining 2 FSWs reported not to have stopped sexual intercourse and no any other actions were taken after the condom failure.ConclusionWe report some inadequate behaviors among FSWs after condom failure. Health programs should develop interventions and support the performance of safer sex and actions after condom failure among FSWs to prevent STIs including HIV, and unplanned pregnancies. Interpersonal, structural and policy factors hindering FSWs’ access to perform effective interventions need to be addressed.

Highlights

Little is known about actions taken by female sex workers (FSWs) after male condom failure during male–female sexual intercourse
In Malawi the Human immunodeficiency virus (HIV) prevalence among adult general population is around 8.8%, [11] while HIV infections prevalence among FSWs is estimated at 62.7% [12]
The remaining 2 FSWs reported not to have stopped sexual intercourse and no any other actions were taken after the condom failure

Summary

Introduction

Little is known about actions taken by female sex workers (FSWs) after male condom failure during male–female sexual intercourse. The objective of this study was to investigate the actions taken by FSWs after condom failure among FSWs in semi-urban, Blantyre in Malawi. Little is known about actions taken by female sex workers (FSWs) during male–female sex after condom failure in semi-urban Blantyre, Malawi. Condom failures are common among FSWs and they expose FSWs and their clients to STIs including HIV, and unplanned pregnancies [6,7,8,9]. The HIV prevalence among FSWs is estimated to be higher than the general population [10]. It is important to explore actions taken by female FSWs after condom failure

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