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.