Preventive behaviors against HIV transmission adopted by Japanese commercial sex workers (CSWs)

To assess self-protective behaviors of commercial sex workers (CSWs) against HIV transmission, a consecutive study was conducted at an obstetric-gynecology clinic in the largest "soapland" area in Tokyo. Among 208 CSWs interviewed, only half (107) regularly requested (RR) the clients to use condoms. Sixty-two percent of RR had learned from others ("learners") oral application of condoms while only 39% of NRR (non-regular requesters) did ("non-learners") (p = 0.001). Seventy-six percent of the learners were only "rarely" or "never" detected by the clients regarding condom application compared with only 23% of the non-learners (p< 0.001). While 90% of additionally recruited 40 NRR reported that they would request condom use by a "suspicious" client, none had experienced violence even when the clients found the secretive application. The oral application of condoms appears to be a transferable and potentially effective preventive behavior.