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Female Sex Worker Client Behaviors Lead to Condom Breakage: A Prospective Telephone-Based Survey in Bangalore, South India

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Abstract

We examined condom breakage rates and predictors of breakage in a prospective telephone-based study of female sex workers (FSWs) in Bangalore, India. We obtained data on 3,257 condom-use sex acts, and breakage occurred in 2.1 % of these. Situational factors, especially those associated with male clients’ behaviors, were the most important predictors of breakage, including sexual inexperience, roughness and violence. Breakage was also associated with having vaginal and anal sex at the same encounter and with poor-fitting condoms. Despite lower than expected breakage rates, the high client volume of FSWs means that there are many unprotected sex acts caused by breakage. Discussions should be held around new education messages, and how programs can respond quickly when sex workers encounter clients who are inebriated, violent or unusually sexually charged. More work is urgently needed with police, and on FSW empowerment, the use of help lines, and counseling for the most vulnerable women.

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Notes

  1. Some women had more than one sex act on the last day of calling (after 14 sex acts) and these were also included in the analysis.

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Acknowledgments

This research was funded by the Bill & Melinda Gates Foundation. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Bill & Melinda Gates Foundation. We would like to thank the study interviewers, staff of Swati Mahila Sangha and all the women who participated.

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Authors and Affiliations

  1. CHARME-India Project, Bangalore, India KHPT Office, IT Park 5th Floor, #1–4 Rajajinagar Industrial Area, Behind KSSIDC Admin Office, Rajajinagar, Bangalore, 560044, India

    Janet Bradley & S. Rajaram

  2. Centre Hospitalier Affilié Universitaire de Québec, Unité de Recherche en Santé des Populations, Centre de Recherche du CHA de Québec, Hôpital du Saint-Sacrement, 1050 Chemin Ste-Foy, Quebec, QC, G1S 4L8, Canada

    Janet Bradley & Michel Alary

  3. Karnataka Health Promotion Trust, IT Park 5th Floor, #1–4 Rajajinagar Industrial Area, Behind KSSIDC Admin Office, Rajajinagar, Bangalore, 560044, India

    S. Rajaram, Stephen Moses, B. M. Ramesh, Shajy Isac & Anil Lobo

  4. Centre for Global Public Health, Faculty of Medicine, University of Manitoba, 771 Mc Dermot Avenue, Medical Rehabilitation Building, Room R070, Winnipeg, MB, R3E 0T6, Canada

    Stephen Moses & B. M. Ramesh

  5. Swasti-Health Resource Centre, Part of Catalyst Group, #19 1st Main, 1st Cross, Aswathnagar, R.M.V 2nd Stage, Bangalore, 560094, India

    G. Chandrashekhar Gowda & Hareesh Gowda

  6. Swathi Mahila Sangha, 52, 4th Main, Postal Colony, Sanjaynagar, Bangalore, 560094, India

    R. Pushpalatha

  7. Imperial College, South Kensington Campus, London, SW7 2AZ, UK

    Marie-Claude Boily

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  1. Janet Bradley
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  2. S. Rajaram
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  3. Stephen Moses
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  4. G. Chandrashekhar Gowda
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  6. B. M. Ramesh
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  7. Shajy Isac
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  8. Marie-Claude Boily
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  9. Anil Lobo
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  10. Hareesh Gowda
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  11. Michel Alary
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Correspondence to Janet Bradley.

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Bradley, J., Rajaram, S., Moses, S. et al. Female Sex Worker Client Behaviors Lead to Condom Breakage: A Prospective Telephone-Based Survey in Bangalore, South India. AIDS Behav 17, 559–567 (2013). https://doi.org/10.1007/s10461-012-0192-3

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  • DOI: https://doi.org/10.1007/s10461-012-0192-3

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