Contraception and Condom Use Among Bolivian Female Sex Workers: Relationship-Specific Associations Between Disease Prevention and Family Planning Behaviors

Abstract

We examined data from a clinic-based survey of 1,222 Bolivian female sex workers (FSWs) to assess whether use of nonbarrier modern contraception is associated with less consistent condom use with clients and noncommercial partners. Women who were using nonbarrier modern contraception were less likely than nonusers to consistently use condoms with noncommercial partners (AOR 0.393, 95% CI 0.203-0.759, p = .005). With clients, this inverse association did not hold. Public health professionals must consider both disease prevention and pregnancy prevention needs in this vulnerable population, and messages should be tailored to encourage dual method use with all partners.

Sex with sweethearts: Exploring factors associated with inconsistent condom use among unmarried female entertainment workers in Cambodia

“…The use of non-barrier contraception was also associated with inconsistent condom use with non-commercial partners among FSWs in Bolivia [17] and Swaziland [36]. Such practices may put FEWs at great risk for HIV and STI acquisition and transmission.…”

“…It also highlights the importance of programmatic promotion of dual protection method, using condoms in conjunction with other modern contraceptive methods that may increase protection against both HIV and unwanted pregnancies [36, 37]. However, consistent condom use remains the most feasible and effective dual protection strategy [17, 36]. …”

“…Excessive alcohol drinking has been found to be associated with both unprotected sex and a history of STIs among FSWs in China [15] and Uganda [16]. In Bolivia, women who used non-barrier modern contraception were less likely to consistently use condoms with non-commercial partners than non-users [17]. In terms of sexual behaviors, the risk of inconsistent condom use decreased when the number of sexual partners increased [18].…”

Meeting the Reproductive Health Needs of Female Key Populations Affected by HIV in Low‐ and Middle‐Income Countries: A Review of the Evidence

“…Most FSWs report using condoms with clients, but they are less likely to use protection with noncommercial or nonpaying partners, such as boyfriends, husbands, or regular lovers (Voeten ; Hoffman ; Ramanaik ; Deering ). A study in Swaziland noted that 69 percent of FSWs reported consistent condom use with new clients in the past month, but 32 percent had used condoms consistently with noncommercial partners and 23 percent had done so with all partners in this period (Yam ). Similarly, among FSWS in Guinea, reported inconsistent condom use was rare with clients (1.3 percent) but frequent with regular nonclient partners (80.4 percent) (Aho, Koushik, and Rashed ).…”

Understanding Sociocultural Factors Contributing to HIV Risk Among Ayoreo Bolivian Sex Workers

“…This latter practice leads us to understand that consistent condom use is not established within the population studied (López-Entrambasaguas, Fernández-Sola &, Granero-Molina, 2013), an issue examined in other research carried out with different aboriginal groups (Mill et al, 2011). Furthermore, it has been shown that women who use other contraceptive methods are less likely to use condoms (Yam et al, 2013). The greater vulnerability to STIs and the consequences these women face are applicable not only to their partners and clients but also to their possible newborn babies.…”