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Behaviour
Condom use by female sex workers and their clients in Mexico: who decides and does it matter?
  1. Annick Bórquez,
  2. Timothy B Hallett,
  3. Gabriela B Gomez,
  4. Geoffrey P Garnett
  1. Department of Infectious Disease Epidemiology, Imperial College, London, UK
  1. Correspondence to Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK; annick.borquez06{at}imperial.ac.uk

Abstract

Objectives To explore the effect of different patterns of condom use by clients and female sex workers (FSW) on HIV transmission in Mexico.

Methods Data from 2401 face-to-face interviews among FSW from Morelos and Michoacán in Mexico were used to build and parameterise a deterministic model of HIV transmission between FSW, their stable partners and clients.

Results For the observed patterns of condom use among FSW, a range of patterns of use among clients would be consistent. Two extreme patterns were explored: either clients conformed to FSW decision, or they had a strict preference for bought sex with or without condoms. HIV prevalence in the model is greater in the first of these scenarios.

Conclusions Patterns of condom use between sex workers and clients are an important, but hidden, determinant of epidemic spread. More detailed information on condom use negotiation and behavioural patterns of clients is needed to understand the potential for transmission in these populations and in order to direct intervention efforts more effectively.

  • Condom
  • HIV
  • mathematical model
  • sex work (prostitution)
  • sexual behaviour

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/sti.2010.048736

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    Footnotes

    • Funding This study was funded by the Medical Research Council and the Wellcome Trust.

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval This study was conducted with the approval of the scientific, ethical and biosecurity boards of the National Institute of Public Helath in Mexico (INSP).

    • Provenance and peer review Not commissioned; not externally peer reviewed.