A survey of condom use among female sex workers in Northern Sydney; declining condom use for fellatio

Int J STD AIDS. 2021 Dec;32(14):1326-1337. doi: 10.1177/09564624211040951. Epub 2021 Sep 15.

Abstract

Condom use among female sex workers (FSWs) is dynamic. We conducted a survey, by anonymous questionnaire, of condom use among FSWs routinely attending our clinical service in Northern Sydney. Logistic regression models determined associations with inconsistent condom use. All 201 women approached completed a questionnaire. Chinese-born women comprised 67% of participants. The median age was 35 years. Clients requesting unprotected fellatio was reported by 95% of participants, and approximately two-thirds felt pressure to have unprotected fellatio and vaginal sex (VSI). Inconsistent condom use at work was reported by 74% for fellatio and by 24% for VSI. The strongest adjusted association with inconsistent condom use for fellatio was monetary inducement by clients (aOR = 40.7, 95% CI 4.87-340, p = 0.001). The only other significant adjusted association was age ≥ 30 years (p = 0.02). The strongest adjusted association with inconsistent condom use for VSI was also monetary inducement by clients (aOR = 56.1, 95% CI 9.26-340, p < 0.001). Other significant adjusted associations were Chinese-speaking participants (p = 0.03) and clients requesting unprotected VSI (p = 0.02). We report high levels of inconsistent condom use. Health promotion should assist FSWs, particularly those of Chinese ethnicity, develop skills in dealing with pressure for unprotected sex, particularly fellatio.

Keywords: Condoms; female sex workers; prostitution; sex work; sexually transmitted infections.

MeSH terms

  • Adult
  • Condoms
  • Cross-Sectional Studies
  • Female
  • HIV Infections* / prevention & control
  • Humans
  • Safe Sex
  • Sex Workers*
  • Surveys and Questionnaires