Nevada's Licensed Sex Workers Achieve Minimal Condom Breakage Rates

Abstract

Nevada is the only US state to have legalized commercial sex. A law has also been in place in Nevada since 1988 mandating compulsory condom use among licensed prostitutes and their clients. To explore the incidences of condom breakage and slippage among regular condom users researchers collected relevant retrospective and prospective data during August 1993 from 41 licensed female prostitutes working in three legal brothels in Nevada. The participants were at least 18 years old (average age 29 years) had worked in a brothel for at least one month and were scheduled to work the three days following the interview. 68% were White 11% Black and 20% Hispanic Asian or of mixed racial background. The women reported engaging in an average of 34 acts of vaginal intercourse during the week preceding the interview. Each woman used a condom with every act of vaginal intercourse with a brothel client. In their prospective reports for the week preceding the study the women indicated that fewer than 0.2% of condoms broke and fewer than 1% fell off. This prospective data covered 353 acts of protected vaginal intercourse over a nine-day period. Overall just 0.6% of condoms fell off during intercourse and 3-4% either slipped during intercourse or slipped during withdrawal. There was a significantly higher probability that a condom would slip during withdrawal among women who had worked in the brothel for less than two years than among those who had worked there longer. Strategies used most often by the women to prevent breakage were the addition of water-based lubricant to the condom (64%) constantly monitoring its condition (20%) refraining from vigorous sex (18%) using more than one condom at a time (9%) using only condoms of the appropriate size (5%) and changing condoms during prolonged intercourse (5%). The researchers assert that these rates of condom breakage are the lowest which have been published to date. It appears from these findings that correct and consistent condom use reduces the incidence of condom breakage and slippage. The strategies adopted by these women to prevent condom slippage and breakage should be promoted more widely.