Constraints faced by sex workers in use of female and male condoms for safer sex in urban Zimbabwe
Constraints faced by sex workers in use of female and male condoms for safer sex in urban Zimbabwe
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DOI：
10.1093/jurban/78.4.581
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发表时间：
2001-12-01
影响因子：
6.6
通讯作者：
Maposhere, C
中科院分区：
文献类型：
--
作者：
Ray, S;van de Wijgert, J;Maposhere, C
我们调查了哈拉雷的性工作者是否接受女用避孕套，以及获得男用和女用避孕套的机会是否增加了与客户和男友发生保护性行为的比例。性工作者被随机分组，分别接受男用和女用避孕套(A组，n=99)或仅使用男用避孕套(B组，n=50)，并前瞻性地对每个人进行约3个月的随访。我们在我们的队列中发现了相当大的人类免疫缺陷病毒(HIV)和性传播感染(STI)的负担(86%的人检测出HIV阳性，34%的人至少有一种STI)。在两周后，从注册到第一次跟踪提示期间，与客户一致的男用避孕套使用率在A组从0%增加到52%，在B组从0%增加到82%，并在整个研究过程中保持在较高水平。在A组中，很少有女性报告与客户始终如一地使用女用避孕套(3%-9%)，而且在整个研究过程中，在男友中使用女用避孕套的比例低于与客户使用避孕套的比例(不同研究小组、不同访客和不同类型的避孕套使用的比例为8%-39%)。无保护措施的性行为仍在发生，性传播感染的发病率为每100名妇女发生16起--经过数月的随访。我们的问卷调查数据显示，女性避孕套的自我报告接受度很高，但焦点小组讨论显示，女性避孕套使用的主要障碍是客户对陌生方法的不信任。这项研究表明，改善获得避孕套的简单干预可以导致性工作者和性服务对象之间更安全的性行为。然而，要帮助性工作者在非商业性关系中实现更安全的性行为，还需要更多的工作。
We investigated whether female condoms are acceptable to sex workers in Harare and whether improved access to male and female condoms increases the proportion of protected sex episodes with clients and boyfriends. Sex workers were randomly placed in groups to receive either male and female condoms (group A, n = 99) or male condoms only (group B, n = 50) and were followed prospectively for about 3 months each. We found a considerable burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) in our cohort at enrollment (86% tested HIV positive and 34% had at least one STI). Consistent male condom use with clients increased from 0% to 52% in group A and from 0% to 82% in group B between enrollment and first follow-tip 2 weeks later and remained high throughout the study. Few women in group A reported using female condoms with clients consistently (3%-9%), and use of either condom was less common with boyfriends than with clients throughout the study (8%-39% for different study groups, visits, and types of condom). Unprotected sex still took place, as evidenced by an STI incidence of 16 episodes per 100 woman-months of follow-up. Our questionnaire data indicated high self-reported acceptability of female condoms, but focus group discussions revealed that a main obstacle to female condom use was client distrust of unfamiliar methods. This study shows that a simple intervention of improving access to condoms can lead to more protected sex episodes between sex workers and clients. However, more work is needed to help sex workers achieve safer sex in noncommercial relationships.