Condom Use, negotiation skills and challenges among urban female sex workers in Sri Lanka

Introduction According to the mapping, 14,312 female sex workers (FSW) are estimated in Sri Lanka, with over half (51%) residing in the Western Province, Colombo district accounted for 44%. The majority of FSWs solicit their... [ view full abstract ]

Introduction
According to the mapping, 14,312 female sex workers (FSW) are estimated in Sri Lanka, with over half (51%) residing in the Western Province, Colombo district accounted for 44%. The majority of FSWs solicit their clients at public places, including streets (42%), while 28% solicit in hotels/guest houses, and 22% in homes/shanties. Integrated bio behavioral survey in 2014 showed that condom use among FSWs during Last Casual Sex was 93% and their HIV prevalence 0.8%, which was higher than the general population (0.1%).

Objective - To assess condom use, negotiation skills and challenges among Sri Lankan FSWs.

Methodology -Four focus group discussions were carried out among FSWs currently engaged in sex work,in urban settings of four districts in Sri Lanka, with a total of 34. All of them were street based sex workers. Guide for focus group discussions were used for the discussions.

Results
All most all FSWs used condoms continuously and depended on free condoms through Global fund interventions. Half of them have alternative methods in situations where they do not have condoms. More than half of their clients did not like condoms due to diminished sexual satisfaction and it was identified as a major challenge. Few had problems of continuing condom use due to lack of negotiation skills. There were certain number of incidents where bursting and slipping of condoms were reported. Myths and lack of skills on how to use condoms correctly still existed. Few had history of arrest due to processing of condoms in past.Out of the thirty four, twenty five (25) participants started using condoms for sex work and they had been motivated to use condoms by sex worker organizations.

Conclusions
Condom use among FSWs are satisfactory. Myths and lack of negotiation skills still existed among them. Quality skill based education programmes should be planed