Assessment of Consistent Condom Use Among Commercial Sex Workers in Addis Ababa, a Comparative Study Comparing Commercial Sex Workers on and out of Intervention
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Date
2016-11
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Addis Abeba Universty
Abstract
Background: HIV prevalence among sex workers is higher than in any other group because of multiple sexual partners and inconsistent use of condoms. The rate of condom use in commercial sex workers is low as they do not always use condoms. Correct and consistent condom use is an effective method of preventing sex workers, their clients and the general population from HIV, Sexually Transmitted Illness and unwanted pregnancy. No attempt was done to assess the effect of intervention on consistent condom use among commercial sex workers.
Objective: To compare consistent condom use among commercial sex workers on and out of intervention, assess association of intervention utilization and consistent condom use and explore main reasons compromising consistent condom use in Addis Ababa, 2016
Method: A cross-sectional study triangulated with qualitative design was employed among 562 commercial sex workers in Addis Ababa from September, 2015 to June, 2016. Multi-stage sampling was used to select sex workers from randomly selected sub-cities. The quantitative data was cleaned, entered and analyzed through Epi-Info version7 and SPSS version 20.0. First distribution of variables was presented by using tables and descriptive statistics to calculate some statistical data and then logistic regression model were used to measure magnitude of consistent condom use among intervention users and non-users. The qualitative method was conducted using in-depth interviews of small sample of key informants and the data were analyzed using the qualitative thematic analysis approach.
Results: The overall prevalence of consistent condom use was 305(54.3%) and the prevalence of consistent condom use among project users and non-users was 185(65.8%) and 120(42.7%) respectively (P-value=0.000).Utilization status of the intervention, having a boyfriends, substance use and access for free condoms were significantly associated with consistent condom use. Project beneficiaries were 2.1(95%CI(1.389,3.286)times more likely to use condoms consistently compared to project non-users. Sex workers who had no boyfriends were 5.1(95%CI(3.479,7.570)times more likely to engage in consistent condom use compared to those having boyfriends. Commercial sex workers who did not abuse substances were 2.0(95%CI(1.361,2.952) times more likely to consistently use condoms compared to their counterparts and commercial sex works who got free condoms were1.6(1.016,2.448)times more likely to use condoms consistently compared to counterparts. Higher payment from a client, client refusal, Substance use like alcohol, unavailability of condoms, pressure from working place, clients belief of condom reduces sexual pleasure were the main reasons for not using condoms consistently.
Conclusion: The magnitude of consistent condom use among commercial sex workers was low. Utilization status, having boyfriends, substance use and access for free condoms were significantly associated with consistent condom use. A significant number of sex workers ever had unprotected sex that might lead them to HIV and sexually transmitted infections. Non-users of the intervention were at a significantly lower rate of consistent condom use than users, thus non-users should also be given due emphasis.
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Assessment of Consistent Condom Use among Commercial Sex Workers in Addis Ababa