Inconsistent Condom Use Among Female Sex Workers: Partner-specific Influences of Substance Use, Violence, and Condom Coercion

A Systematic Review of Factors Influencing Condom Use among Female Sex Workers

“…Another study found similar results, with 34.8% of FSWs reporting client-perpetrated violence (Decker et al, 2019). Interestingly, Decker et al, (2019) found that client perpetrated violence was more common among FSWs who had recently experienced intimate partner violence (IPV) (62.5%, P < 0.001). This study also concluded that inconsistent condom use in commercial settings was influenced by coercive condom negotiation driven by client intoxication and violence (Decker et al, 2019).…”

“…In one study, 30% of FSWs reported sexual abuse and 17.5% reported physical abuse with the most common perpetrators of sexual abuse being clients (50.9%) and stable partners (28.8%), while clients were also the most common perpetrators of physical abuse (57%), followed by stable partners (22%), other sex workers (19%) and police officers (6%) (Rwema et al, 2019). Another study found similar results, with 34.8% of FSWs reporting client-perpetrated violence (Decker et al, 2019). Interestingly, Decker et al, (2019) found that client perpetrated violence was more common among FSWs who had recently experienced intimate partner violence (IPV) (62.5%, P < 0.001).…”

“…Interestingly, Decker et al, (2019) found that client perpetrated violence was more common among FSWs who had recently experienced intimate partner violence (IPV) (62.5%, P < 0.001). This study also concluded that inconsistent condom use in commercial settings was influenced by coercive condom negotiation driven by client intoxication and violence (Decker et al, 2019). Many FSWs perceived that asking a client to use a condom would result in the client becoming violent, with many of these participants reporting prior abuse from clients (Darbinyan, Lang, Diclemente, Joseph & Markosyan, 2011).…”

“…Thirteen of the included studies cited drug and alcohol use as a factor of inconsistent condom use in commercial sex (Maher 2013;Bui 2013;Jung 2013;Munoz;Decker;Barrington;Zhang 2011;Shannon 2009;Grayman 2005;Alam 2013;Choi 2007;Thorpe 1997;Cusick 1998). Drug and alcohol use among both FSWs and male clients was found to negatively affect condom use.…”

“…Client intoxication often made condom negotiation by the FSW difficult, and strategies that were normally used such as sweet talk and appealing to the client"s health were less effective (Maher et al, 2013). Intoxication of the client was found to have a negative effect on consistent condom use, whereas intoxication of the FSW was more likely to have an effect on non-consistent condom use with a non-paying partner, with one study finding that substance abuse by the FSW was not the influencing factor in condom use and was rather the partner type (Decker et al, 2019). Barrington et al, (2009) found similar results for male client intoxication, stating that male clients who drank less than a few times per week were almost three times more likely to consistently use condoms when compared with clients who consumed alcohol at least a few times per week (OR 2.77, 95% CI = 1.28-6.02).…”