Actions of female sex workers faced with condom failure during penetration sexual encounters with clients in Cape Town

Mukumbang, Ferdinand Chemungha (2014-04)

Thesis (MPhil)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT: Male latex condoms have empirically been established as one of the effective barrier prevention methods against HIV transmission and are thus widely recommended. Meanwhile, there are a copious number of studies supporting its effectiveness; there have also been reports of condom breakages and slippages during heterogeneous vaginal intercourse, which undermines its primary goal as a barrier prevention method. The rate of condom failure is even higher among sex workers as the nature of their work is characterised by frequent coitus. This, consequently, increases the susceptibility of sex workers and their clients to contracting HIV and other sexually transmissible diseases. The situation is made dire due to the criminalisation, stigmatisation and discrimination of sex workers. While so much has been done to investigate the use, effectiveness, and failure rates of condoms among various populations, there is a troubling research gap regarding the actions of female sex workers when they are faced with situations of condom failure. This study revealed that, with respect to the immediate actions of sex workers after a condom failure incident, about 36% of the respondents revealed that they continued with their sexual rapport to the end even after noticing that the condom is broken. Another 36% said that they stopped immediately they noticed that the condom broke or slipped. Some 13% of the participants pointed that they stopped the sexual encounter completely. Another 3% revealed that they applied vaginal spermicidal foam. About 5% of the respondents said that they stopped immediately and took a douche when they had the chance. For the actions within the next 24 hours of experiencing condom failure with a client, 53% of the participants reported doing, meanwhile 4% attested of seeking counsel from a professional. About 3% of the respondents revealed that they simply took alcohol or drugs to forget the incident and 25% said that they went to the clinic for assistance when they experienced condom failure. Meanwhile, some of the actions such as continuing the sexual encounter without a new condom, taking alcohol and drugs or doing nothing at all could increase the risk of contracting HIV, other actions such as stopping the sexual completely, paying a visit to a clinic or visiting a professional could make a difference between staying HIV negative or becoming HIV positive.

AFRIKAANSE OPSOMMING: Latex kondome vir mans is bewys as een van die mees effektiefste metodes teen die vookoming van MIV-oordrag en word dus wyd aanbeveel. Alhoewel daar 'n oorvloed aantal studies is wat die doeltreffendheid daarvan ondersteun, is daar ook talle studies van kondome wat breek en lek tydens heterogeen vaginale omgang. Dus ondermyn dit die primêre doel van die kondoom as verspreidings voorkomingsmiddel. Die koers van kondoom mislukking is selfs hoër onder sekswerkers as gevolg van die aard van hul werk, wat gekenmerk word deur gereelde seksuele omgang. Dit verhoog sekswerkers en hul kliënte se blootstelling aan MIV en ander seksueel oordraagbare siektes en word vererger te danke aan die kriminalisering, diskriminasie en stigmatisering van ‘n sekswerker se beroep. Daar is tans baie navorsing oor die gebruik, doeltreffendheid, en mislukking van kondome onder verskillende bevolkingsgroepe, maar ‘n kommerwekkende gaping ten opsigte van die optrede van die vroulike sekswerkers wanneer hulle gekonfronteer word met situasies van kondoom mislukking. So ‘n studie toon dat met betrekking tot die onmiddellike optrede van sekswerkers na 'n kondoom mislukking voorval, sowat 36% van hulle voortgegaan met die seksuele daad, selfs al is hulle bewus van die gebreekte kondoom. ‘n Verdere 36% het gesê dat hulle onmiddellik gestop het, nadat hulle opgemerk het die kondoom het gebreek of gegly. 13% van die deelnemers het daarop gewys dat hulle glad nie voortgegaan het met die seks daad nie. Nog 'n verdere 3% het aangedui dat hulle ‘n vaginale spermisidiese skuim aangewend het. Ongeveer 5% van die deelnemers het onmiddellik gestop en so gou moontlik van ‘n douche-stort gebruik gemaak. In verband met hul optrede/aksie binne die volgende 24 uur na die insident, het 53% van die deelnemers dit gerapporteer, en 4% het ‘n professionele persoon geraadpleeg. Sowat 3% van die deelnemers het getoon dat hulle alkohol of dwelms gebruik het om van die voolval te vergeet en 25% het hul kliniek om hulp gevra. Wanneer daar geen aksie geneem word na die mislukking van ‘n kondoom nie, byvoorbeeld om voort te gaan met die sekuele daad en nie ‘n nuwe kondoom te gebruik nie, of om na drank en dwels te draai, verhoog die kanse om die MIV virus oor te dra. ‘n Positiewe reaksie, byvoorbeeld om onmiddelik op te hou met die seksuele daad en ‘n kliniek te besoek, kan die verskil maak tussen MIV-negatief en MIV-positief.

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