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Early sex work initiation and condom use among alcohol-using female sex workers in Mombasa, Kenya: a cross-sectional analysis
  1. Angela M Parcesepe1,2,
  2. Kelly L L'Engle3,4,
  3. Sandra L Martin1,
  4. Sherri Green1,
  5. Chirayath Suchindran5,
  6. Peter Mwarogo6
  1. 1Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
  2. 2HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, New York, USA
  3. 3FHI 360, Durham, North Carolina, USA
  4. 4Population Health Sciences, School of Nursing and Health Professions, University of San Francisco, San Francisco, California, USA
  5. 5Department of Biostatistics, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
  6. 6FHI 360, Nairobi, Kenya
  1. Correspondence to Dr Angela M Parcesepe, HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, 1501 Riverside Drive, New York, NY 10032, USA; ap3471{at}cumc.columbia.edu

Abstract

Objectives Early initiation of sex work is prevalent among female sex workers (FSWs) worldwide. The objectives of this study were to investigate if early initiation of sex work was associated with: (1) consistent condom use, (2) condom negotiation self-efficacy or (3) condom use norms among alcohol-using FSWs in Mombasa, Kenya.

Methods In-person interviews were conducted with 816 FSWs in Mombasa, Kenya. Sample participants were: recruited from HIV prevention drop-in centres, 18 years or older and moderate risk drinkers. Early initiation was defined as first engaging in sex work at 17 years or younger. Logistic regression modelled outcomes as a function of early initiation, adjusting for drop-in centre, years in sex work, supporting others and HIV status.

Results FSWs who initiated sex work early were significantly less likely to report consistent condom use with paying sex partners compared with those who initiated sex work in adulthood. There was no significant difference between groups in consistent condom use with non-paying sex partners. FSWs who initiated sex work early endorsed less condom negotiation self-efficacy with paying sex partners compared with FSWs who did not initiate sex work early.

Conclusions Findings highlight a need for early intervention for at-risk youth and adolescent FSWs, particularly in relation to HIV sexual risk behaviours. Evidence-based interventions for adolescent FSWs or adult FSWs who began sex work in adolescence should be developed, implemented and evaluated.

  • HIV
  • AFRICA
  • WOMEN
  • PROSTITUTION

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