Sexual and health practices of Bolivian female sex workers: A survey in six cities

Background: Current data is scarce regarding the sexual and health behaviors of Bolivian female sex workers (FSWs). We sought to document the sexual and health practices of FSWs in six Bolivian cities. Methods: Female study staff conducted interviewer-administered face-to-face surveys of FSWs aged 18 and over in public clinics in Cochabamba, El Alto, La Paz, Oruro, Santa Cruz, and Sucre. Results: 1,252 women agreed to participate. Nearly half (47.4%) had been previously diagnosed with an STI. The vast majority reported that in the past month, they always used condoms with both established clients (87.1%) and new clients (89.6%). However, of the 813 (64.9%) that had regular partners, just 8.9% always used condoms with them. More than 96% stated they had vaginal sex with established and unknown clients as well as with partners. More than 99% reported they never had dry sex with any type of client or partner and more than 85% stated they never had anal sex with any clients or partners. More than half reported that they never had oral sex with established clients, unknown clients, or with partners. Of the 619 (49.4%) that reported using vaginal douches, 35.4% did so daily. Conclusions: Bolivian FSWs use condoms regularly with clients, but are much less diligent about condom use with regular partners. Vaginal douching is a common practice that should be discouraged by future educational efforts.