Understanding the dynamics of condom use among female commercial sex workers in Durban Central South Africa.

Abstract

Despite the disastrous effects the HIV and AIDS pandemic has on economies of developing countries, sexual behaviour change has been gradually improving, but the epidemic prevalence remains above 10% in most Southern African countries. Econometric studies have shown a strong correlation between HIV/AIDS infection and casual sex. Where commercial sex is legalised, research studies indicate a decline in sexually transmitted infections (STIs), including HIV. A few African countries have made positive strides towards legalising commercial sex which could in some way contribute to curbing the spread of HIV among sex workers. It has been argued that while condom use is increasing in most African countries including South Africa, it remains low and inconsistent. Given that prevention is the mainstay of the response to HIV/AIDS, this research study pursued understanding the dynamics of condom use among female commercial sex workers (FCSWs). The investigation focused on understanding what determines condom use among FCSWs, whilst advancing the notion that men ought to be involved in HIV intervention programmes. Twelve in-depth interviews were conducted with FCSWs in Durban, South Africa. The research results suggested that barriers to condom use still exist in the form of drug and substance abuse, myths about the role of circumcision, retrogressive cultures, violence, competition for clients, and victimisation of sex workers by law enforcement agents, among other factors. Given these barriers, it could be argued that condom use interventions have, to a greater extent, managed to contain HIV infection rates rather than stop them, hence the need for more comprehensive condom use research, especially with sex workers who have multiple partners. Alternatively, sex work should be legalised as this legalisation is strongly associated with condom use among FCSWs.