“I Use Strawberry Flavoured Condoms during My Periods”:

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dc.contributor.authorBongomin, Felix
dc.contributor.authorKibone, Winnie
dc.contributor.authorPebalo, Francis Pebolo
dc.contributor.authorLaker, Fiona Gladys
dc.contributor.authorOkot, Jerom
dc.contributor.authorKaducu, Felix Ocaka
dc.contributor.authorMadraa, Grace
dc.contributor.authorLabongo Loum, Constantine Steven
dc.contributor.authorAwor, Silvia
dc.contributor.authorNapyo, Agnes
dc.contributor.authorMusoke, David
dc.contributor.authorOuma, Simple
dc.date.accessioned2023-11-24T13:03:43Z
dc.date.available2023-11-24T13:03:43Z
dc.date.issued2023-08-28
dc.description.abstractBackground: Female sex workers (FSWs) are at a higher risk of contracting and transmitting HIV and other sexually transmitted infections (STIs). We aimed to explore the sexual behaviour, knowledge and attitudes towards STIs, barriers, support and intervention for STI screening. Methods: In this community-based, concurrent quantitative–qualitative, exploratory mixed-methods study, we administered 87 semi-structured quantitative and six in-depth interviews to purposively select FSWs in Gulu City, Uganda. The qualitative methodology was based on descriptive phenomenology. Results: The quantitative study included 87 FSWs, with a median age of 28 years. Overall, 87.4% (n = 76) participants reported condom use during their last sexual encounter. Eighty-three (95.4%) participants were aware of their HIV status, with 6% (n = 5) reporting being HIV-positive. Seventy-six (87.4%) participants reported contracting at least one STI during sex work. In addition, 66.7% (n = 58) of the participants reported being screened for STIs in the past three months, with vulvovaginal candidiasis (55.3%, n = 42) and syphilis (32.9%, n = 25) being the most common STIs. However, only 2.3% (n = 2) of the participants reported current STIs symptoms. In the qualitative study, the main themes encompassed sexual behaviour, including condom-use negotiation strategies and challenges, as well as screening facilitators and barriers. Condom-use negotiation tactics involved leveraging healthrisk information, increased charges for unprotected sex, and outright refusal. Complex challenges included limited agency in promoting safe sex due to economic reliance, vulnerability to violence, and difficulties in controlling the sexual environment. Facilitators for regular screening included social influences, emotional relief, established testing habits, and accessible clinics, while barriers encompassed cost, stigma, doubts about test accuracy, and inconvenient clinic hours. Conclusions: FSWs face significant vulnerabilities in Gulu City, Uganda, regarding STIs. While encouraging trends such as high HIV awareness and condom usage were observed, persistent challenges in STI screening, negotiation of safe sex practices, and access to prevention and treatment remain evident. To address these concerns, targeted interventions should be developed to enhance STI screening accessibility empower sex workers with effective negotiation skills, and provide comprehensive support for STI prevention and treatment, thereby contributing to improved overall sexual health and well-being among this marginalized populationen_US
dc.description.sponsorshipA seed grant from the Centre for International Reproductive Health Training (CIRHT) at The University of Michigan, the United States of Americaen_US
dc.identifier.citationBongomin, F., Kibone, W., Pebolo, P. F., Laker, F. G., Okot, J., Kaducu, F. O., ... & Ouma, S. (2023). “I Use Strawberry Flavoured Condoms during My Periods”: Safe Sex Practices and STI Screening Behaviours among Female Sex Workers in Gulu City, Uganda. Venereology, 2(3), 108-123.en_US
dc.identifier.urihttps://doi.org/10.3390/ venereology2030010
dc.identifier.urihttps://hdl.handle.net/20.500.14270/354
dc.language.isoenen_US
dc.publisherMDPIen_US
dc.relation.ispartofseries. Venereology;2023, 2, 108–123
dc.subjectsafe sexen_US
dc.subjectfemale sex workersen_US
dc.subjectscreening behavioursen_US
dc.subjectSTIen_US
dc.subjectHIVen_US
dc.title“I Use Strawberry Flavoured Condoms during My Periods”:en_US
dc.title.alternativeSafe Sex Practices and STI Screening Behaviours among Female Sex Workers in Gulu City, Ugandaen_US
dc.typeArticleen_US

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