Condom Use Among Female Sex Workers in the Greater Accra Region

Abstract

Background Female sex workers are a group of people who are important in the transmission of HIV. Studies have shown that they are a source of HIV infections to both their commercial and non- commercial partners. Regular condom use has been proven to remarkably reduce the transmission of sexually transmitted infections (STIs) and thereby its importance for the success of any STI/HIV control programme. This study was therefore designed to assess condom use among female sex workers and to elicit information on factors that influence condom use. Method This was a cross-sectional study using mixed method (quantitative and qualitative). Four hundred females who are roamers were recruited from three popular sites using systematic sampling technique. Two focus group discussions were also held with female sex workers who are seaters to elicit normative views on condom use. Bivariate and multivariate regression models were used to establish the relationship between independent variables and the dependent variables. Qualitative data were audio taped, transcribed and analyzed thematically. Results Knowledge on HIV transmission was high among both Roamers (98%) and seaters. Condom use was lower among non-commercial partners (9.7%) than commercial (11.7%). Knowledge on the use of condoms to prevent HIV was widespread but this did not transform into safe sex practices. Customer demand and use of alcohol were important social barriers in the use of condom. Perceived vulnerability, barriers to condom use and self-efficacy were key determinants in condom use. Conclusion Knowledge on modes of transmission of HIV especially through unprotected sexual intercourse with an infected individual was high, however, unsafe sexual practices was still common among female sex workers. Prevalence of condom use was high among paying partners than non-paying partners as a means to establish trust in the relationship. Social factors such as customer demand and use of alcohol and other drugs were barriers to condom use and should be given more attention. The availability of condom did not determine consistent condom use. Perception of vulnerability cues to action, and barrier were predictors of condom use.