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Associations Between Economic Factors and Condom Use Behavior Among Female Sex Workers in Dakar and Mbour, Senegal

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Abstract

Condom use remains a mainstay of HIV prevention programs around the world. However, data characterizing economic determinants of condom use among female sex workers (FSW) are limited, including in Senegal. We recruited 718 FSWs via respondent-driven sampling. Bivariate and multivariable regressions were conducted to assess the associations between economic variables and condom use at last sex. Paying rent (aRR: 1.07, 95%CI 1.01–1.13) was positively associated with condom use at last sex with new clients. No statistically significant associations were found between condom use and financial responsibility for dependent children, having additional source of income, sharing sex work earnings, or the ability to borrow from other FSWs, regardless of sexual partner types. The relationship between economic marginalization and consistent condom use among sex workers is complex reinforcing the need for behavioral economic research and prevention to be integrated into HIV prevention and treatment research and programs.

Resumen

El preservativo continúa siendo el pilar de los programas de prevención del VIH en el mundo. Sin embargo, los datos de la caracterización de los determinantes económicos del uso del preservativo entre las trabajadoras del sexo (TDS) son escasos, incluyendo Senegal. Se reclutaron 718 TDS a través del respondent-driven sampling. Se realizaron regresiones bivariadas y multivariadas para abordar las asociaciones entre variables económicas y el uso del preservativo en el último coito. Pagar alquiler (aRR: 1.07, 95% CI: 1.01-1.13) estuvo positivamente asociado al uso del preservativo en el último coito con nuevos clientes. Asociaciones no estadísticamente significantes fueron encontradas entre el uso del preservativo y responsabilidad financiera sobre un hijo dependiente, fuentes de ingresos adicionales, reparto del dinero del trabajo sexual, o la posibilidad de tomar prestado dinero de otra TDS, independiente del tipo de pareja sexual. La relación entre la marginalización económica y el uso consistente del preservativo entre las trabajadoras del sexo es complejo, reforzando la necesidad de investigar el comportamiento económico y de prevención para ser integrados en los programas de prevención y tratamiento del VIH.

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Acknowledgements

HIV Prevention 2.0 (HP2): Achieving an AIDS-Free Generation in Senegal is supported by the United States Agency for International Development (USAID) under Cooperative Agreement No. AID-OAA-A-13-00089. HP2 is managed by Johns Hopkins University. We are thankful to the participants in our study and field staff who contributed to the data collection. We thank Drs. Tiago Canelas and Jessica Rothstein for their help translating the Abstract from English to Spanish.

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Authors and Affiliations

  1. Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, USA

    Fan Yang, Sosthenes Ketende, Carrie E. Lyons, Benjamin Liestman, Karleen Coly, Gnilane Turpin & Stefan Baral

  2. Department of International Health, Johns Hopkins University School of Public Health, Baltimore, USA

    Fan Yang, Larissa Jennings Mayo-Wilson & Caitlin Kennedy

  3. School of Medicine, University of North Carolina, Project-China, Guangzhou, China

    Fan Yang

  4. Enda Santé, Dakar, Senegal

    Daouda Diouf & Fatou M. Drame

  5. Gaston Berger University, Saint-Louis, Senegal

    Fatou M. Drame

  6. Institut de Recherche en Santé, de Surveillance Epidemiologique Et de Formations, Dakar, Senegal

    Souleymane Mboup & Nafissatou Leye-Diouf

  7. Laboratoire de Bacteriologie-Virologie, CHU Aristide Le Dantec, Dakar, Senegal

    Souleymane Mboup, Coumba Toure-Kane & Halimatou Diop-Ndiaye

  8. USAID, Office of HIV/AIDS, Bureau for Global Health, Arlington, VA, USA

    Delivette Castor & Alison Cheng

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  1. Fan Yang
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Yang, F., Ketende, S., Jennings Mayo-Wilson, L. et al. Associations Between Economic Factors and Condom Use Behavior Among Female Sex Workers in Dakar and Mbour, Senegal. AIDS Behav 24, 2829–2841 (2020). https://doi.org/10.1007/s10461-020-02832-2

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