Patterns of Partnership and Condom Use in Two Communities of Female Sex Workers in Tanzania

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Two rapid ethnographic studies have found that commercial sex workers (CSWs) and other high-risk women in Tanzania have different categories of partners, ranging from single-time contacts to long and enduring relationships. Since the advent of HIV/AIDS prevention programs in Tanzania in the late 1980s, CSWs and their clients have been aware of the multiple benefits of condom use for the prevention of pregnancy and STDs including HIV. These women often use condoms for the single-time contact. However, since the HIV/AIDS epidemic, casual partners have decreased in number. These days, most of their sexual contacts occur within long-term partnerships, and within these relationships, condom use is rare. Although the message that condoms should be used during high-risk behavior has been largely accepted, the definition of a high-risk relationship needs to be extended from casual partnerships to include multiple long-term partnerships. In addition, men and women's empowerment through education, business, and equal rights needs to be addressed at all levels of society.

Section snippets

Methodology

In 1991 and 1993, two studies using rapid ethnographic techniques were conducted with two groups of high-risk women to examine their partnerships and their beliefs and behaviors with regard to STDs and HIV/AIDS. The purpose of the studies was to gain an in-depth understanding of the environment in which the women and their partners meet and interact and to provide insight into the best methods for promoting behavior change among them.

The first group studied were women, and most of them were

Characteristics of the Two Groups of Women

The two study populations had different characteristics. At the four truck stops, of approximately 400 women, 128 were interviewed during the ethnographic study and 121 answered an anonymously recorded KAP questionnaire. The population of women at the truck stops consisted of barmaids, hotel workers, pombe (local brew) sellers, and freelance CSWs, representing almost every region in Tanzania. All but 3 were 34 years old or younger; their average age was 24. Only 4 had any postprimary education.

Discussion

The studies reported here are especially important because CSWs form a core group in the spread of HIV/STD (Plummer et al., 1991). They are “that subset of the population in which the infection is present and that sustains sex partner exchange rates greater than the critical threshold” (Brunham & Ronald, 1991).

In general, women in Tanzania are poor and undereducated. More than 90% live without electricity, and four fifths live on dirt floors. In 1991-1992, only 4% of women ages 25 to 34 had any

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    This work was supported in part by the U.S. Agency for International Development (USAID) as part of Family Health International's AIDSTECH and AIDS Control and Prevention (AIDSCAP) Project (623-0238-A-00-4031-00) and does not necessarily reflect the views or policies of USAID.

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