Prevalence of Consistent Condom Use and Associated Factors among Female Sex workers in the districts of Rakai and Kyotera, South western Uganda.

Abstract

Background:Despite the fact that condoms can reduce HIV transmission, levels of condom use are low among female sex workers (FSW). This study examines prevalence of consistent condom use and associated factors among 602 FSW in Rakai and Kyotera districts. Methods:In this cross-sectional descriptive study, secondary quantitative data that were collected between July 2016 and September 2018 were obtained with permission from Rakai Health Sciences Program (RHSP), while in June 2022; in-depth interviews were conducted with FSWs through CHEDRA (Community Health Empowerment Development and Relief Agency) to address the qualitative objective. Results: Only 52% of FSWs reported using condoms consistently in heterosexual relationships in the past 12 months. Consistent condom use was mainly influenced by client preference and peer influence. Independent factors associated with lower risk of consistent condom use were: Presence of sexual violence [adjusted prevalence ratios (aPR) 0.79; 95% confidence interval (CI): 0.68-0.92], Engagement in non-marital sexual relationships (aPR 0.67; 95% CI: (0.58-0.77), High risk perception of HIV acquisition (aPR 0.68; 95% CI: 0.59-0.79) and Lack of knowledge of HIV status (aPR 0.29; 95% CI: 0.11-0.73). Conclusion: Consistent condom use was lower among female sex workers who experienced sexual violence, it was lower among those who were engagement in non-marital sexual relationships, it was also lower among those who had high risk perception of HIV acquisition, and among those who did not know their HIV results. Recommendation: Tailored strategies to increase consistent condom use should be designed targeting FSWs who are more vulnerable to HIV infection, alongside efforts to reduce all forms of violence and to increase HIV status awareness among this population.