The Condom Conundrum: Barriers to Condom Use among Commercial Sex Workers in Durban, South Africa

Abstract

We examined socio-cultural and economic determinants of condom use among 100 female South African commercial sex workers. The symbolism and dynamics of condom use between sex workers and their clientele were explored. These issues were also investigated when sex workers negotiated sex with their personal partners. An additional focus was the extent to which HIV/AIDS influences women's condom use in these situations. Results demonstrate considerable contrast between factors influencing condom use in professional versus private sex situations. With clients, practical issues such as financial strain were the major obstacles to condom use. With personal sex partners, sex workers avoided condoms due to their negative symbolism. Condoms were seen as suggestive of filth, disease, infidelity, and mistrust. HIV/AIDS awareness had minimal impact on condom use. HIV/AIDS was viewed as a remote threat, overridden by immediate practical and emotional concerns. The intervention implications of condom symbolism and differential barriers to condom use are discussed.

Taxi ‘sugar daddies’ and taxi queens: Male taxi driver attitudes regarding transactional relationships in the Western Cape, South Africa

“…While much of the early research on transactional sex, including that of more formalised sex work, has focused on women's experiences and vulnerability to HIV/AIDS (Abdool Karim, Abdool Karim, Soldan & Zondi 1995;Campbell 1991;Varga 1997), there have been more recent calls to acknowledge the complexity of transactional sex and avoid a woman-as-victim discourse (Leclerc-Madlala 2008). A number of studies show how young women are also invested in transactional relationships with more resourced and older men for both status and access to material goods, and may be active participants in these partnerships (Jones 2006;Nkosasana & Rosenthal 2007;Silberschmidt & Rasch 2000).…”

Sexual behaviour patterns in South Africa and their association with the spread of HIV: insights from a mathematical model

“…Although this has been a popular avenue of research, some critics have argued that this focus on high risk groups, rather than on high risk behaviours, is stigmatizing and unhelpful (Wojcicki and Malala 2001;Varga 1997a), and others have argued that sexual behaviour patterns in the broader population may play a more important role in HIV transmission dynamics (Helleringer and Kohler 2007). Our analysis suggests that, although commercial sex accounted for around 6% of new HIV infections in South Africa in 1990, when the epidemic was in its early stages, the proportion of new HIV infections currently occurring in commercial sex encounters is only about 1%.…”

“…Women are assumed to become sex workers at a rate sufficient to meet the male demand for commercial sex, with the relative rates of entry into sex work at different ages being determined in such a way that the age distribution of sex workers is consistent with that observed in a study of sex workers in Johannesburg (Rees et al 2000). Studies suggest that South African sex workers usually have between 20 and 25 sex acts with clients per week (Ramjee, Weber, and Morar 1999;Abdool Karim et al 1995;Rees et al 2000;Varga 1997a), and on the basis of this evidence, it is assumed that sex workers have an average of 1,000 sex acts with clients per annum.…”

Les problèmes attribués à la théorie du choix rationnel

“…En fait, il y a passablement de preuves qu'un comportement sexuel à risque comporte des calculs. Dans la littérature sur la transmission du vih, par exemple, on constate que les prostituées sont plus susceptibles d'utiliser un condom pour leurs relations avec leurs clients que pour celles avec leurs partenaires à long terme où, présumément, la lubricité intervient (Albert, Warner et Hatcher, 1998 ;Varga, 1997) ; on constate aussi que l'utilisation du condom est plus courante dans les relations à court terme que dans les relations à long terme (Anderson et coll., 1990). De toute évidence, il y a là une certaine réflexion sur les conséquences.…”