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

Abstract Background 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. Methods A 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. Results Study 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. Conclusion We 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.

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

10.21203/rs.3.rs-31147/v1 ◽

2020 ◽

Author(s):

Donatien Twizelimana ◽

Adamson S Muula

Keyword(s):

Sexual Intercourse ◽

Health Care Providers ◽

Sex Workers ◽

Access To Health Care ◽

Female Sex Workers ◽

Hormonal Contraceptives ◽

Post Exposure Prophylaxis ◽

Care Providers ◽

Female Sex ◽

Study Participants

Abstract Background Little is known about action taken by female sex workers (FSWs) after condom failure during 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. Methods A 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. Results Study participants reported different actions taken after condom failure. Many FSWs reported to have stopped sex immediately and changed the condom and then resumed sexual intercourse. Other than condom replacement no further actions were taken. Few FSWs reported to have stopped sexual intercourse and thereafter sought medical care which included post-exposure prophylaxis for HIV, sexually transmitted infections’ treatment, and emergency hormonal contraceptives. Urination, vaginal douche, and squatting after condom failure were reported as actions taken by some participants with the aim to avoid HIV transmission and pregnancy. Some FSWs interviewed reported to have not stopped sexual intercourse and no any other actions were taken after condom failure. Some FSWs reported to have douched, squatted or asked for higher pay from their clients after condom failure. Conclusion We reported some inadequate behaviors among FSWs after condom failure. Health programs should develop interventions for safe sex among FSWs to prevent STIs including HIV, and unplanned pregnancies. There is a need to address misconceptions related to health illiteracy among FSWs. There are interpersonal, structural and policy factors hindering FSWs’ access to health care providers.

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HIV and AIDS risk perception among sex workers in semi-urban Blantyre, Malawi

Tanzania Journal of Health Research ◽

10.4314/thrb.v17i3.5 ◽

2015 ◽

Vol 17 (3) ◽

Author(s):

Adamson Muula ◽

Donatien Twizelimana

Keyword(s):

Risk Perception ◽

Sex Workers ◽

Female Sex Workers ◽

Unprotected Sex ◽

Hiv And Aids ◽

Consistent Condom ◽

Cross Sectional ◽

Female Sex ◽

Male Clients ◽

Study Participants

Background: Several health behaviour theories propose that risk perception affects the likelihood of behaviour intentions and practice. The perception of risk to HIV and AIDS among female sex workers in Malawi has not been well described. Yet knowledge of how this most at risk population perceives contagion could help in informing the design, implementation and monitoring of interventions.Methods: A cross sectional, qualitative study was conducted among female sex workers in Blantyre, Malawi between 2013 and 2014. Snowballing technique was used to recruit study participants. In depth interviews were done by six trained female research assistants among 45 female sex workers. Data were analysed using thematic content analysis.Results: There were mixed perceptions of risk to HIV infection among the sampled sex workers. While some of the study participants perceived themselves as at higher risk of acquiring infection, some considered themselves to be at no higher risk than the general population. Some study participants suggested that married women in stable relationship were at higher risk of infection than the female sex workers. Prayer and belief in God were reported to be protective from HIV acquisition while predestination or mere talking about HIV was perceived to result in vulnerability to infection. In terms of overall knowledge about HIV, this was assessed as high. Several barriers to consistent condom use were reported: non-availability at all times, high cost and unacceptable instructions of the female condom, offers of higher pay for unprotected sex by male clients and harassment and forced unprotected sex by police.Conclusions: We have reported expression of dissonance, fatalism and predestination among female sex workers in semi-urban Malawi is responses to the threat of HIV. There is need to develop context-specific safer sex programs among female sex worker in Malawi.

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Factors associated with retention in HIV prevention and treatment clinical services among female sex workers enrolled in a sex workers’ outreach program (SWOP) in Nairobi, Kenya.

10.21203/rs.3.rs-715524/v1 ◽

2021 ◽

Author(s):

Patrick Eshikumo ◽

Patrick Awuor ◽

Natalia Blanco ◽

Marie-Claude Lavoie ◽

Anna Whittington ◽

...

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Cohort Analysis ◽

Outreach Program ◽

Post Exposure Prophylaxis ◽

Female Sex ◽

Prevention And Treatment ◽

Hiv Acquisition ◽

Exposure Prophylaxis

Abstract Female sex workers (FSWs) are among the key populations (KP) prioritized for comprehensive HIV programming in Kenya. Retention in the program is critical for prevention of HIV acquisition and transmission among FSWs and their sexual partners. We conducted a retrospective cohort analysis of data collected from FSWs enrolled between October 2016 and September 2017 at seven drop-in centers (DICs) in Nairobi, Kenya, to examine retention in HIV prevention and treatment services and identify the associated factors. We found a 3- and 12- month retention of 24% and 17%, respectively. FSWs aged 20-34 years old were less likely to be retained compared to those 50 years or older. FSWs enrolled in a DIC located in their sub-county of residence or reporting ever using HIV pre- or post-exposure prophylaxis were more likely to be retained. Identifying predictors of FSWs disengagement from HIV services can inform the design and implementation of retention-enabling interventions.

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Sexual IPV and non-partner rape of female sex workers: findings of a cross-sectional community-centric national study in South Africa

SSM - Mental Health ◽

10.1016/j.ssmmh.2021.100012 ◽

2021 ◽

pp. 100012

Author(s):

Rachel Jewkes ◽

Kennedy Otwombe ◽

Kristin Dunkle ◽

Minja Milovanovic ◽

Khuthadzo Hlongwane ◽

...

Keyword(s):

South Africa ◽

Sex Workers ◽

Female Sex Workers ◽

National Study ◽

Cross Sectional ◽

Female Sex

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Association between treatment for gonorrhoea and chlamydia and lower condom use in a cross-sectional study of female sex workers in southern India

BMJ Open ◽

10.1136/bmjopen-2015-009774 ◽

2016 ◽

Vol 6 (5) ◽

pp. e009774

Author(s):

Marianne Legendre-Dugal ◽

Janet Bradley ◽

Subramanian Potty Rajaram ◽

Catherine M Lowndes ◽

Banadakoppa M Ramesh ◽

...

Keyword(s):

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Southern India ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex

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Early sex work initiation and condom use among alcohol-using female sex workers in Mombasa, Kenya: a cross-sectional analysis

Sexually Transmitted Infections ◽

10.1136/sextrans-2016-052549 ◽

2016 ◽

Vol 92 (8) ◽

pp. 593-598 ◽

Cited By ~ 9

Author(s):

Angela M Parcesepe ◽

Kelly L L'Engle ◽

Sandra L Martin ◽

Sherri Green ◽

Chirayath Suchindran ◽

...

Keyword(s):

Condom Use ◽

Sex Work ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional ◽

Female Sex ◽

Cross Sectional Analysis ◽

Sectional Analysis

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Do female sex workers have lower uptake of HIV treatment services than non-sex workers? A cross-sectional study from east Zimbabwe

BMJ Open ◽

10.1136/bmjopen-2017-018751 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018751 ◽

Cited By ~ 3

Author(s):

Rebecca Rhead ◽

Jocelyn Elmes ◽

Eloghene Otobo ◽

Kundai Nhongo ◽

Albert Takaruza ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Household Survey ◽

Hiv Treatment ◽

Sample Survey ◽

Physical And Mental Health ◽

Hiv Knowledge ◽

Cross Sectional ◽

Female Sex ◽

Treatment Services

ObjectiveGlobally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake.MethodsData from a household survey conducted in 2009–2011 and a parallel snowball sample survey of FSWs were matched using probability methods to reduce under-reporting of FSWs. HIV treatment cascades were constructed and compared for FSWs (n=174) and NSWs (n=2555). Determinants of service uptake were identified a priori in a theoretical framework and tested using logistic regression.ResultsHIV prevalence was higher in FSWs than in NSWs (52.6% vs 19.8%; age-adjusted OR (AOR) 4.0; 95% CI 2.9 to 5.5). In HIV-positive women, FSWs were more likely to have been diagnosed (58.2% vs 42.6%; AOR 1.62; 1.02–2.59) and HIV-diagnosed FSWs were more likely to initiate ART (84.9% vs 64.0%; AOR 2.33; 1.03–5.28). No difference was found for antiretroviral treatment (ART) adherence (91.1% vs 90.5%; P=0.9). FSWs’ greater uptake of HIV treatment services became non-significant after adjusting for intermediate factors including HIV knowledge and risk perception, travel time to services, physical and mental health, and recent pregnancy.ConclusionFSWs are more likely to take up testing and treatment services and were closer to achieving optimal outcomes along the cascade compared with NSWs. However, ART coverage was low in all women at the time of the survey. FSWs’ need for, knowledge of and proximity to HIV testing and treatment facilities appear to increase uptake.

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Are Truckers Being over Stigmatized as HIV Carriers in India? Evidences from Behavioral and Biological Cross-Sectional Surveys among Clients of Female Sex Workers

Open Journal of Preventive Medicine ◽

10.4236/ojpm.2015.53010 ◽

2015 ◽

Vol 05 (03) ◽

pp. 85-91

Author(s):

Damodar Sahu ◽

Sowmya Ramesh ◽

Ram Manohar Mishra ◽

K. Srikanth Reddy ◽

Reena Bharadwaj ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional ◽

Female Sex

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“The Drug Will Help Protect My Tomorrow”: Perceptions of Integrating PrEP into HIV Prevention Behaviors Among Female Sex Workers in Lilongwe, Malawi

AIDS Education and Prevention ◽

10.1521/aeap.2019.31.5.421 ◽

2019 ◽

Vol 31 (5) ◽

pp. 421-432

Author(s):

Jaclyn Shea ◽

Agatha Bula ◽

Wezzie Dunda ◽

Mina C. Hosseinipour ◽

Carol E. Golin ◽

...

Keyword(s):

Hiv Prevention ◽

Sexual Behaviors ◽

Sex Workers ◽

Female Sex Workers ◽

Economic Effects ◽

Sub Saharan Africa ◽

Prevention Strategies ◽

Female Sex ◽

Hiv Prevention Strategies ◽

Hiv Acquisition

Female sex workers (FSW) are disproportionately at risk for HIV. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, yet approaches for incorporating PrEP within prevention strategies used by FSW are lacking. Semistructured focus group discussions were conducted with 44 HIV-negative FSW in Lilongwe, Malawi to explore perceptions of PrEP: acceptability, integration within HIV prevention behaviors, and barriers to use. Acceptability of PrEP was high. Motivation to use PrEP was rooted in love for one's life, anticipated negative economic effects associated with HIV acquisition. PrEP was viewed as complementary to existing norms for engaging in healthy sexual behaviors. Many felt PrEP may provide extra protection from HIV, along with condoms and frequent STI testing. Unpredictable daily lives, stigma, and side effects were barriers that could affect PrEP use. Leveraging existing HIV prevention strategies and social norms surrounding HIV prevention behaviors may positively impact PrEP uptake among FSW in Malawi and sub-Saharan Africa.

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The Risk Factors Analysis Occurrence of Chlamydia Infection to Direct Female Seks Workers (DFSW) in Indonesia

E3S Web of Conferences ◽

10.1051/e3sconf/20186801024 ◽

2018 ◽

Vol 68 ◽

pp. 01024

Author(s):

Masayu Gemala Rabiah ◽

Rini Mutahar ◽

Rico Januar Sitorus

Keyword(s):

Risk Factors ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Chlamydia Infection ◽

Female Sex Worker ◽

Cross Sectional ◽

Sex Worker ◽

Female Sex ◽

The Government

Chlamydia infection is one of the most common sexually transmitted infections worldwide. Based on data of IBBS 2015 in Indonesia, the highest prevalence of chlamydia occurred in direct female sex worker group (32.21%). This study a STIs to determine the risk factors for chlamydia infection in direct sex workers. This research uses Cross-Sectional study design. The population of this study were all direct female sex workers as many as 3,789 people with samples in accordance with inclusion and exclusion criteria as many as 3.114 people. The prevalence of direct female sex workers with chlamydia infection was 1.018 (32.4%). The result of the analysis showed that there was a relationship between age (PR: 0.541 95% CI: 0.456-0.643) and length of work as FDSW (PR: 1,.60, 95% CI: 1.087-1.512) chlamydia infection in female sex workers in Indonesia. most dominant variable has an effect on the incidence of chlamydia infection that is long working as FDSW after controlled by age (PR 1.282 95% CI: 1.087-1,.12). It is expected for the government to improve the implementation of prevention program of chlamydia not only among female sex worker but also proactive to customer.

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