Client-perpetuated violence and condom failure among female sex workers in southwestern China

This research examined factors associated with condom failure, i.e., slippage or breakage, among female sex workers (FSWs) in China. Special attention was paid to the association between client-perpetuated violence and condom failure.

Two hundred FSWs were recruited for a community-based voluntary human immunodeficiency virus prevention project. Participants completed a face-to-face structured questionnaire that collected information on their sociodemographic characteristics, working conditions, experience of client-perpetuated violence, and sexual risk behavior.

The prevalence of condom slippage and condom breakage in the 3 months before the survey was reported at 36.2% and 34%, respectively, of all sexual contact in which a condom was used. The prevalence of client-perpetuated violence in the previous year was 68.4%. Logistic regression analysis showed that after adjusting for other factors, condom failure was significantly associated with drug use [adjusted odds ratios (aOR = 4.01)], condom use of coworkers (aOR = 0.39), and client-perpetuated violence [aOR = 2.30 (low violence vs. high violence)].

Condom failure is a common problem among FSWs, particularly drug-using sex workers and those who have experienced client-perpetuated violence. On the other hand, condom use of coworkers is negatively associated with condom failure.