Condoms used but sex not well protected

Area of Science:

• Public Health
• Epidemiology
• Sexually Transmitted Infections

Background:

• Condom use is widely promoted as safer sex, particularly among female sex workers (FSW).
• High condom use prevalence among FSW in China has been observed.
• However, condom failure and improper use remain significant risks for HIV transmission.

Purpose of the Study:

• To investigate the prevalence of condom failure and improper use among FSW in Shenzhen, China.
• To identify factors associated with condom failure and improper use.
• To assess the implications for HIV prevention strategies.

Main Methods:

• A cross-sectional study involving interviews with 195 FSW in Shenzhen, China.
• Data collected on condom use, condom failure, improper condom use, and associated factors.
• Analysis of individual, interpersonal, and environmental/structural factors.

Main Results:

• 97.4% of FSW reported condom use in the last sex work episode.
• 53.8% experienced condom failure (e.g., breakage, slippage, removal by clients).
• 86.2% reported improper condom use (e.g., not removing air, poor fit, low quality).
• Individual, interpersonal, and environmental factors were linked to condom failure and improper use.

Conclusions:

• Despite high reported condom use, frequent condom failure and improper use compromise protection for FSW in China.
• HIV prevention interventions need to address condom effectiveness and socio-ecological factors.
• Condom use alone is not equivalent to protected sex; further interventions are crucial.