AEGiS-13IAC: Male clients of female prostitutes (FP) in Benin, West Africa: factors associated with condom use.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Male clients of female prostitutes (FP) in Benin, West Africa: factors associated with condom use.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. MoOrC245)

Alary M, Lowndes CM, Gnintoungbe CA, Bedard E, Jossou P, Mukenge L, Lafia E, Anagonou S
M. Alary, Epidemiology Research Group, Hopital du St-Sacrement du CHA, 1050 Chemin Sainte-Foy, Quebec G1S 4L8, Canada, Tel.: +1 418 682 73 87, Fax: +1 418 682 79 49, E-mail: malary@gre.ulaval.ca

BACKGROUND: To investigate factors associated with condom use by male clients of FP in Cotonou, Benin.

METHODS: 404 male clients of FP were recruited on-site at prostitution venues in Cotonou, and provided a urine sample (for HIV and STD testing) before having sex with a FP. After having sex they underwent a 15-30 minute interview on socio-demographics, sexual and health-seeking behaviour.

RESULTS: Median age of clients was 25.5 (range 17-53) years; two-thirds (66.7%) were Beninese and 80% were married or had a regular girlfriend. Median price paid to the FP just seen was $US 1 (range $0.6-$6); 56% of clients had used a condom with the FP just seen and 54% reported always or often using condoms with FP in general. Using binomial regression analysis, condom use (always/often) with FP was more frequent among clients with a higher educational level (adjusted prevalence ratio [APR] = 1.52; p = 0.0003), who paid a higher price for sex with FP (APR = 1.49; p = 0.0062), who did not use STD prophylaxis (APR = 1.27; p = 0.048), who used condoms with non-FP sex partners (APR = 1.47; p = 0.005), as well as in clients with a lifetime history of STD (APR = 1.25; p = 0.038). Condom use by clients was not associated with age, marital or conjugal status, length of time since visiting FP, frequency of visits to FP or number of different FP seen in the last 3 months. Condom use rates with FP also varied significantly according to the location of the prostitution site in Cotonou.

CONCLUSIONS: Condom use with FP was strongly associated with the educational level of the clients in this study, as well as with higher price paid to FP for sex. The latter result suggests that the practice of offering more money to a FP in order not to use a condom may be infrequent in this context. Clients who use condoms with FP also use condoms more frequently with non-FP regular and casual partners, while use of medication as prophylaxis for STDs appears to have a negative effect on condom use rates by clients with FP. The data also suggest that the experience of having a STD may influence subsequent condom use with FP.

Keywords: AEGIS, Safe Sex, Condoms, Prostitution, Sexual Partners, Benin, HIV Infections, Prevalence, Africa, Condoms, Female, Interviews, Male, Human, Female
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MoOrC245