Determinants of consistent condom use among female sex workers in Savannakhet, Lao PDR.

Carin Hillerdal Andrews,Vanphanom Sychaerun,Ketkesone Phrasisombath,Elisabeth Faxelid

doi:10.1186/s12905-015-0215-0

Carin Hillerdal Andrews, Vanphanom Sychaerun + Show 2 more

Open Access

https://doi.org/10.1186/s12905-015-0215-0

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Abstract

BackgroundFemale sex workers (FSWs) are a high-risk population for HIV. Correct and consistent use of condoms is the most effective measure for reducing transmission of HIV. Lao PDR is a low HIV-prevalence country, but FSWs have a relatively high HIV prevalence. To be able to make recommendations for condom promotion interventions in Lao PDR it is important to know more about the context specific situation. This study looked at reasons for and associated factors of consistent condom use among FSWs.MethodsA cross-sectional survey among 258 FSWs in Kaysone Phomvihan district in Savannakhet province was performed.ResultsAlmost all FSWs had enough condoms (94 %), condoms always available (100 %) and could always afford condoms (92 %). Consistent condom use was 97% with non-regular partners and 60% with regular partners. Almost all respondents (95 %) had received information about condoms from the drop-in centre. Stated reasons for consistent condom use were prevention of HIV (94 %), STIs (88 %) and pregnancy (87 %). Most reasons for inconsistent condom use were related to partners not wanting to use condoms because of reduced sexual pleasure. Some FSWs reported that they were physically abused and forced not to use condoms. Shorter time in sex work, higher education and FSW not having regular partners were significantly associated with consistent condom use.ConclusionsConsistent condom use was very high with non-regular partners, but less frequent with regular partners. The main reason for inconsistent condom use was that the partner did not want to use a condom. Associated factors for consistent condom use were not having regular partners, higher education and shorter time in sex work. Condom promotion programs should include both FSWs and their partners and female condoms should be included in condom intervention efforts. Future studies should investigate the validity of self-reported sexual practices, partners’ reasons for inconsistent condom use, risk of violence in sex work and why shorter time in sex work is associated with consistent condom use.

Highlights

Female sex workers (FSWs) are a high-risk population for HIV
Andrews et al BMC Women's Health (2015) 15:63 though Lao PDR is classified as a low HIV prevalence country with 0.2% of adults aged 15–49 estimated to be HIV positive, the prevalence is higher among FSWs compared to the general population at between one and four percent [5, 7]
Future studies should investigate the validity of self-reported sexual practices among FSWs in Lao PDR

Summary

Introduction

Female sex workers (FSWs) are a high-risk population for HIV. Correct and consistent use of condoms is the most effective measure for reducing transmission of HIV. One of the major factors in the spread of the epidemic in the region is high HIV prevalence among female sex workers (FSWs) [1]. One hundred percent condom use programs that target FSWs have been introduced with promising results in several South East Asian countries and were introduced in Lao PDR in 2003 [6]. Andrews et al BMC Women's Health (2015) 15:63 though Lao PDR is classified as a low HIV prevalence country with 0.2% of adults aged 15–49 estimated to be HIV positive, the prevalence is higher among FSWs compared to the general population at between one and four percent [5, 7].

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