Increasing safe sex behavior among female sex workers (FSW) through promotion of female condoms (FC) in three states of India

BACKGROUND

PSI-India is implementing a FC promotion program in selected districts of Jharkhand, Orissa & Rajasthan states among FSWs, as a complementary method of protection against HIV/ AIDS, sexually transmitted infection (STI) and unwanted pregnancy. The intervention aims to enhance the number of protected sex acts by promoting FC where use of male condom is unlikely.

METHODOLOGY

A cross-sectional baseline survey was conducted among FSWs to identify and prioritize determinants of current use of FC . Two-stage stratified cluster sampling was used, sample 640 FSWs in each state. Logistic regression examined relationships between the determinants and the promoted behaviour.

RESULTS

Self reported consistent condom use with non paying partners (17%) was much less than paying clients (71%), current use of FC was 2.5% and 12.1% respectively. Predictors of FC use with non paying partners were investigated. Perceived availability of FC (OR=1.72); attitudes towards FC use (OR=1.84) and ability to negotiate FC use (OR=1.88) were found to be significant determinants of FC use with non paying partners. The program developed a communication strategy with the goal of enhancing perceived availability and positive attitudes towards FC.

CONCLUSIONS

The critical gaps in condom use patterns among FSWs and determinants of FC use with non paying partners were identified. Communication activities like game shows highlighting the pleasure enhancing features of FC and steps for correct use of FC(demonstration) were developed.