7th International AIDS Conference Florence, Italy — June 16-21, 1991

Int Conf AIDS 1991 Jun 16-21; 7:37 (abstract no. W.D.58)
Swaminathan S, Kumaresan G; Institute of Social Affairs, Madras, India

OBJECTIVE: To gain an understanding of the factors which will best increase condom use among commercial sex providers and commercial sex seekers in the city of Madras.

METHODS: In May 1990, 100 female prostitutes were recruited for a pilot study to develop HIV intervention program. A series of focus groups were held to discuss a number of relevant health topics including HIV/AIDS prevention and the use of condoms. A number of factors were found to lead to insufficient condom use by prostitutes and their clients. 1) Feelings of helplessness and lack of social power, which made it difficult for the women to ensure condom use. 2) Worry that requesting the client to use a condom would lead to loss of business. 3) The decision making capacity in using condom rests with the client. 4) Harassment by the authorities for carrying condoms. 5) Lack of availability of condoms at the time in the day when business is at it's peak. 6) A number of women were sterilized, and since condom was perceived as a contraceptive the need to use it did not arise. 7) Doubt was expressed about the ability of the condoms to protect against AIDS, even though there was some awareness about its ability to protect against a number of STD's. 8) Various incorrect beliefs regarding side effects were associated with condom use. Towards later half of 1990, 200 male clients of prostitutes were recruited for a similar research with emphasis on condom use.

RESULTS: The men revealed a number of important misbeliefs. These included: 1) AIDS is a foreign problem. 2) Sexual partners with STD's/AIDS can be readily identified by external appearances. 3) All STD's are curable if treated early and untreated STD's may alone progress on to leprosy or AIDS. 4) Condoms are solely to be used as a contraceptive. 5) Extensive body contact during sexual activity facilitates the spread of STD's and condoms cannot prevent this spread. 6) Condoms were perceived to decrease pleasure in commercial sex sought essentially to derive sexual pleasure.

CONCLUSION: HIV and AIDS intervention targetised at the prostitutes may not have optimal benefit without education based intervention of clients. Such an intervention will promote a climate that will increase possibilities of prostitutes negotiating safe sex service which can lessen the spread of HIV.

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