TY - JOUR
T1 - A qualitative exploration on accounts of condom-use negotiation with clients
T2 - Challenges and predicaments related to sex work among street-based female sex workers in ekurhuleni district, south africa
AU - Sikhosana, Nokuthula
AU - Mokgatle, Mathildah Mpata
N1 - Funding Information:
Data collection was conducted at the Centre for Positive Care offices (CPC), a non-governmental organisation in Gauteng Province. The Centre is funded by the South African Department of Health and it supports the National Strategic Plan of South Africa to reduce HIV, STIs, and TB, and to strengthen reproductive health rights services. The population for the study consisted of the street-based FSWs working in Heidelberg Road, one of the main urban roads in Gauteng Province. For participant recruitment, the site coordinator at CPC assisted with gaining entry to the FSWs as they were accessing their health care services at the Centre. The Centre provided the researcher with peer-educators who accompanied the researcher to the Heidelberg Road, where the FSWs work, to facilitate recruitment. The purpose of the research was shared with the participants.
Publisher Copyright:
Copyright: Nokuthula Sikhosana et al.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Introduction: female sex workers (FSWs) are the key vulnerable populations since they carry the high burden of HIV and sexually transmitted infections (STIs). However, the vulnerability of street-based FSWs to HIV/STIs is much higher than that of the establishment-based FSWs. The study aimed to explore street-based FSWs’ condom negotiation skills, barriers to condom use as well as the challenges and predicaments they face on a daily basis. Methods: an exploratory qualitative approach using focus group discussions was conducted among FSWs working in a major provincial road in a district of Gauteng Province. Thematic content analysis using NVivo version 10 software was conducted. Results: the age range of the FSWs was 19 to 44 years. The themes that emerged from the data on challenges to negotiation and condom use among FSWs revealed the ways condoms are used in early sex work and over time, ways of enforcing condom used, preferred types of condoms and the predicaments to working in the sex trade. FSWs gained experience of negotiating condom use over time in their work. Both female and male condoms were available and accurate insertion of condoms was reported. Male condom was preferred. Condom use strategies included direct request; using health-information messages; charging more for condomless sex; and refusing condomless sex. The FSW reported the risks of violent attacks of unregulated street-based environment. Conclusion: condom negotiation strategies illustrated that peer-education and sharing experiences among themselves were beneficial for protective sexual behaviours. Peereducation benefits and peer-interactions yielded assertive attitudes and behaviours of demanding and/or enforcing condom use.
AB - Introduction: female sex workers (FSWs) are the key vulnerable populations since they carry the high burden of HIV and sexually transmitted infections (STIs). However, the vulnerability of street-based FSWs to HIV/STIs is much higher than that of the establishment-based FSWs. The study aimed to explore street-based FSWs’ condom negotiation skills, barriers to condom use as well as the challenges and predicaments they face on a daily basis. Methods: an exploratory qualitative approach using focus group discussions was conducted among FSWs working in a major provincial road in a district of Gauteng Province. Thematic content analysis using NVivo version 10 software was conducted. Results: the age range of the FSWs was 19 to 44 years. The themes that emerged from the data on challenges to negotiation and condom use among FSWs revealed the ways condoms are used in early sex work and over time, ways of enforcing condom used, preferred types of condoms and the predicaments to working in the sex trade. FSWs gained experience of negotiating condom use over time in their work. Both female and male condoms were available and accurate insertion of condoms was reported. Male condom was preferred. Condom use strategies included direct request; using health-information messages; charging more for condomless sex; and refusing condomless sex. The FSW reported the risks of violent attacks of unregulated street-based environment. Conclusion: condom negotiation strategies illustrated that peer-education and sharing experiences among themselves were beneficial for protective sexual behaviours. Peereducation benefits and peer-interactions yielded assertive attitudes and behaviours of demanding and/or enforcing condom use.
KW - Condom use
KW - Female sex worker
KW - Unprotected sex
KW - Vaginal health
UR - http://www.scopus.com/inward/record.url?scp=85118217660&partnerID=8YFLogxK
U2 - 10.11604/pamj.2021.40.54.29918
DO - 10.11604/pamj.2021.40.54.29918
M3 - Article
C2 - 35059100
AN - SCOPUS:85118217660
VL - 40
JO - Pan African Medical Journal
JF - Pan African Medical Journal
SN - 1937-8688
M1 - 54
ER -