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Intentional and Unintentional Condom Breakage and Slippage in the Sexual Interactions of Female and Male Sex Workers and Clients in Mombasa, Kenya

Authors
  • Masvawure, Tsitsi B.1
  • Mantell, Joanne E.2
  • Tocco, Jack Ume2
  • Gichangi, Peter3, 4, 5
  • Restar, Arjee6
  • Chabeda, Sophie Vusha3
  • Lafort, Yves4
  • Sandfort, Theo G. M.2
  • 1 College of the Holy Cross, Department of Sociology and Anthropology, Worcester, MA, USA , Worcester (United States)
  • 2 New York State Psychiatric Institute and Columbia University, HIV Center for Clinical and Behavioral Studies, New York, NY, USA , New York (United States)
  • 3 International Centre for Reproductive Health, Mombasa, Kenya , Mombasa (Kenya)
  • 4 International Centre for Reproductive Health-Ghent University, Ghent, Belgium , Ghent (Belgium)
  • 5 University of Nairobi, Department of Anatomy, Nairobi, Kenya , Nairobi (Kenya)
  • 6 Brown University, Brown School of Public Health, Providence, RI, USA , Providence (United States)
Type
Published Article
Journal
AIDS and Behavior
Publisher
Springer-Verlag
Publication Date
Oct 03, 2017
Volume
22
Issue
2
Pages
637–648
Identifiers
DOI: 10.1007/s10461-017-1922-3
Source
Springer Nature
Keywords
License
Yellow

Abstract

We examined why male condoms broke or slipped off during commercial sex and the actions taken in response among 75 female and male sex workers and male clients recruited from 18 bars/nightclubs in Mombasa, Kenya. Most participants (61/75, 81%) had experienced at least one breakage or slippage during commercial sex. Many breakages were attributed to the direct actions of clients. Breakages and slippages fell into two main groups: those that were intentionally caused by clients and unintentional ones caused by inebriation, forceful thrusting during sex and incorrect or non-lubricant use. Participant responses included: stopping sex and replacing the damaged condoms, doing nothing, getting tested for HIV, using post-exposure prophylaxis and washing. Some sex workers also employed strategies to prevent the occurrence of condom breakages. Innovative client-oriented HIV prevention and risk-reduction interventions are therefore urgently needed. Additionally, sex workers should be equipped with skills to recognize and manage breakages.

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