Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Women's Health
Published in: BMC Women's Health 1/2011

Open Access 01-12-2011 | Research article

Reasons for non- use of condoms and self- efficacy among female sex workers: a qualitative study in Nepal

Authors: Laxmi Ghimire, W Cairns S Smith, Edwin R van Teijlingen, Rashmi Dahal, Nagendra P Luitel

Published in: BMC Women's Health | Issue 1/2011

Login to get access

Abstract

Background

Heterosexual contact is the most common mode of transmission of sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) in Nepal and it is largely linked to sex work. We assessed the non-use of condoms in sex work with intimate sex partners by female sex workers (FSWs) and the associated self-efficacy to inform the planning of STI/HIV prevention programmes in the general population.

Methods

This paper is based on a qualitative study of Female Sex Workers (FSWs) in Nepal. In-depth interviews and extended field observation were conducted with 15 FSWs in order to explore issues of safe sex and risk management in relation to their work place, health and individual behaviours.

Results

The main risk factor identified for the non-use of condoms with intimate partners and regular clients was low self efficacy. Non-use of condoms with husband and boyfriends placed them at risk of STIs including HIV. In addition to intimidation and violence from the police, clients and intimate partners, clients' resistance and lack of negotiation capacity were identified as barriers in using condoms by the FSWs.

Conclusion

This study sheds light on the live and work of FSWs in Nepal. This information is relevant for both the Government of Nepal and Non Governmental Organisations (NGO) to help improve the position of FSWs in the community, their general well-being and to reduce their risks at work.
Appendix
Available only for authorised users
Literature
1.
Mai TTT, Le CL, Nguyen TL: Factors associated with inconsistent condom use among female sex workers in Nha Trang, Vietnam. Asia-Pac J Public Health. 2008, 20: 370-378. 10.1177/1010539508322485.CrossRef
2.
3.
Ismail R: Sexually transmitted disease (STD) and acquired immunodeficiency syndrome (AIDS) in South East Asia. Clin dermatol. 1999, 17: 127-135. 10.1016/S0738-081X(99)00005-X.CrossRefPubMed
4.
Lomax N, Wheeler H, Anaraki S, Anderson H, Goh B: Management of a syphilis outbreak in street sex workers in east London. Sex Transm Infect. 2006, 82: 437-438. 10.1136/sti.2006.020461.CrossRefPubMedPubMedCentral
5.
Puri M, Cleland J: Sexual and perceived risk of HIV/AIDS among young migrant factory workers in Nepal. J Adolesc Health. 2006, 38: 237-46.CrossRefPubMed
6.
Matsumura M, Gubhaju B: Women's status household structure and the utilisation of maternal health services in Nepal. Asia-Pac Popul J. 2001, 16: 23-44.
7.
Mathur S, Malhotra A, Mehta M: Adolescent girls' aspirations and reproductive health in Nepal. Reprod Health Matters. 2001, 9: 91-100. 10.1016/S0968-8080(01)90012-6.CrossRefPubMed
8.
9.
10.
Silverman JG, Decker MR, Gupta J, Maheshwari A, Willis BM, Raj A: HIV prevalence and predictors of infection in sex-trafficked Nepalese girls and women. JAMA. 2007, 298: 536-542. 10.1001/jama.298.5.536.CrossRefPubMed
11.
12.
Campbell J, Jones AS, Dienemann J, Kub J, Shollenberger , O'Campo P, Glelen AC, Wynne C: Intimate Partner violence and physical health consequences 2002. Arch Intern Med. 162 (1157): 63.
13.
Ellsberg M, Heise L: Bearing witness: Ethics in domestic violence research. The Lancet. 2002, 359: 1599-1604. 10.1016/S0140-6736(02)08521-5.CrossRef
14.
Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD: Transactional sex among women in Soweto, South Africa: Prevalence, risk factors and association with HIV infection. Soc Sci Med. 2004, 59: 1581-1592. 10.1016/j.socscimed.2004.02.003.CrossRefPubMed
15.
Colombini M, Mayhew S, Watts C: Health-sector responses to intimate partner violence in low- and middle-income settings: A review of current models, challenges and opportunities. Bull World Health Organ. 2008, 86: 635-642. 10.2471/BLT.07.045906.CrossRefPubMedPubMedCentral
16.
Dhakal S: Nepalese women under the shadow of domestic violence. The Lancet. 2008, 371: 547-48. 10.1016/S0140-6736(08)60254-8.CrossRef
17.
Tandukar K, Poudel KC, Eto T, Jimba M: Domestic violence against women in Nepal. The lancet. 2008, 371: 1664.CrossRef
18.
Tamang A, Nepal B, Puri M, Shrestha D: Sexual behaviour and risk perception among young men in border town of Nepal. J Asia Pac popul. 2001, 16: 195-210.
19.
Evans C, Lambert H: Health seeking strategies and sexual health among female sex workers in urban India: implications for research services provision. Soc Sci Med. 1997, 44: 1791-1803. 10.1016/S0277-9536(96)00288-2.CrossRefPubMed
20.
21.
Ghimire L, van Teijlingen ER: Barrier to utilisation of sexual health services by female sex workers in Nepal. GJHS. 2009, 1: 12-22.CrossRef
22.
Heckathorn DD: Respondent-driven sampling II: Deriving valid population estimates from chain-referral samples of hidden populations. J L & Soc probs. 2002, 49: 11-34.CrossRef
23.
Vandepitte J, Lyerla R, Dallabetta G, Crabbé F, Alary M, Buvé A: Estimates of the number of female sex workers in different regions of the world. Sex Transm Infect. 2006, 82 (Supplement 3): iii18-iii25.PubMedPubMedCentral
24.
Glaser B, Strauss A: The discovery of grounded theory: Strategies for qualitative research. New York 1967: Aldine Publishing Company
25.
Mason J: Mixing methods in a qualitatively driven way. Qualitative Res. 2006, 6: 9-25. 10.1177/1468794106058866.CrossRef
26.
27.
Gysels M, Pool R, Nnalusiba B: Women who sell sex in a Ugandan trading town: Life histories, survival strategies and risk. Soc Sci Med. 2002, 54: 179-192. 10.1016/S0277-9536(01)00027-2.CrossRefPubMed
28.
Wawer MJ, Podhisita C, Kanungsukkasem U, Pramualratana A, McNamara R: Origins and working conditions of female sex workers in urban Thailand: Consequences of social context for HIV transmission. Soc Sci Med. 1996, 42: 453-462. 10.1016/0277-9536(95)00150-6.CrossRefPubMed
29.
Pyett P, Warr D: Women at risk in sex work: Strategies for survival. AJ S. 1999, 35: 183-197.
30.
Shannon K, Kerr T, Allinott S, Chettiar J, Shoveller J, Tyndall MW: Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work. Soc Sci Med. 2008, 66: 911-921. 10.1016/j.socscimed.2007.11.008.CrossRefPubMed
31.
Varga CA: Coping with HIV/AIDS in Durban's commercial sex industry. AIDS Care. 2001, 13: 351-365. 10.1080/09540120120044008.CrossRefPubMed
32.
Wong ML, Lubek I, Dy BC, Pen S, Chhit M: Social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Combodia. Sex Transm Infect. 2003, 79: 163-65. 10.1136/sti.79.2.163.CrossRefPubMedPubMedCentral
33.
Rao V, Gupta L, Lokshin M, Jana S: Sex workers and the cost of safe sex: The compensating differential for condom use among Calcutta prostitutes. J Devt Econ. 2003, 71: 585-603. 10.1016/S0304-3878(03)00025-7.CrossRef
34.
Lambert LC, Firestone JM: Economic context and multiple abuse techniques. Violence Against Woman. 2000, 6: 49-67.CrossRef
35.
Mayaud P, Mabey D: Approaches to the control of sexually transmitted infections in developing countries: Old problems and modern challenges. Sex Transm Infect. 2004, 80: 174-182. 10.1136/sti.2002.004101.CrossRefPubMedPubMedCentral
36.
Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH: Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence. The Lancet. 2006, 368: 1260-1269. 10.1016/S0140-6736(06)69523-8.CrossRef
37.
Panchanadeswaran S, Johnson SC, Sivaram S, Srikrishnan AK, Latkin C, Bentley ME, Solomon S, Go VF, Celentano D: Intimate partner violence is as important as client violence in increasing street- based female sex workers' vulnerability to HIV in India. Int J Drug Policy. 2008, 19: 106-112. 10.1016/j.drugpo.2007.11.013.CrossRefPubMedPubMedCentral
38.
Mayhew S, Collumbien M, Qureshi A, Platt L, Rafiq N, Faisel A, Lalji N, Hwakes S: Protecting the unprotected: mixed-method research on drug use, sex work and rights in Pakistan's fight against HIV/AIDS. Sex Transm Infect. 2009, 85 (Suppl 2): Ii31-36. 10.1136/sti.2008.033670.CrossRefPubMed
39.
Kumar MS, Virk HK, Chaudhuri A, Mittal A, Lewis G: A rapid situation and response assessment of the female regular sex partners of male drug users in South Asia: Factors associated with condom use during the last sexual intercourse. Int J of Drug Policy. 2008, 19: 148-158. 10.1016/j.drugpo.2007.12.003.CrossRef
40.
Goldin CS: Stigmatization and AIDS: Critical issues in public health. Soc Sci Med. 1994, 39: 1359-1366. 10.1016/0277-9536(94)90366-2.CrossRefPubMed
41.
Day S: Prostitute women and AIDS: anthropology. Jur AIDS. 1988, 2: 421-28. 10.1097/00002030-198812000-00002.CrossRef
42.
Busza J: How does a "risk group" perceive risk? Voices of Vietnamese sex workers in Cambodia. Int J of Psychol and Human Sexuality. 2005, 17: 65-82.
43.
Choudhary E, Coben JH, Bossarte RM: Gender and time differences in the associations between sexual violence victimization, health outcomes, and risk behaviours. Am J Mens Health. 2008, 2: 254-259. 10.1177/1557988307313819.CrossRefPubMed
44.
Basuki E, Wolffers I, Devillé W, Erlaini N, Luhpuri D, Hargono R, Maskuri N, Suesen N, van Beelen N: Reasons for not using condoms among female sex workers in Indonesia. AIDS Educ Prev. 2002, 14: 102-116. 10.1521/aeap.14.2.102.23901.CrossRefPubMed
45.
Ghimire L, Smith WC, van Teijlingen ER: Utilisation of sexual health services by female sex workers of Nepal. BMC Health Serv Res. 2011, 11: 79-10.1186/1472-6963-11-79.CrossRefPubMedPubMedCentral
46.
Beyrer C: Women and girls and the sex industry in Southeast Asia; Political causes and human rights implications. Soc Sci Med. 2001, 53: 543-550. 10.1016/S0277-9536(00)00358-0.CrossRefPubMed
47.
Parker RG, Easton D, Klein CH: Structural barriers and facilitators in HIVprevention: a review of international research. AIDS. 2000, 14: 22-32.CrossRef
48.
Nosaka A, Andrews BW: Institutionalized powerlessness in context: The static and dynamic nature of women's status in rural Bangladesh. Int J Women's Studies. 2004, 6: 149-168.
49.
O'Neil J, Orchard T, Swarankar RC, Blanchard JFJF, Gurav K, Moses S: Dhandha, dharma and disease: traditional sex work and HIV/AIDS in rural India. Soc Sic Med. 2004, 59: 851-860. 10.1016/j.socscimed.2003.11.032.CrossRef
50.
Kerrigan D, Moreno L, Rosario S, Gomez B, Jerez H, Barrington C, Weiss E, Sweat M: Environmental-structural interventions to reduce HIV/STI risk among female sex workers in the Dominican Republic. Am J Public Health. 96: 120-25.
51.
Metadata
Title
Reasons for non- use of condoms and self- efficacy among female sex workers: a qualitative study in Nepal
Authors
Laxmi Ghimire
W Cairns S Smith
Edwin R van Teijlingen
Rashmi Dahal
Nagendra P Luitel
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2011
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/1472-6874-11-42

Other articles of this Issue 1/2011

BMC Women's Health 1/2011 Go to the issue

Research article

Baropodometry on women suffering from chronic pelvic pain - a cross-sectional study

Research article

From papers to practices: district level priority setting processes and criteria for family planning, maternal, newborn and child health interventions in Tanzania

Research article

Phytoestrogen consumption from foods and supplements and epithelial ovarian cancer risk: a population-based case control study

Research article

Frequency of symptoms, determinants of severe symptoms, validity of and cut-off score for Menopause Rating Scale (MRS) as a screening tool: A cross-sectional survey among midlife Nepalese women

Research article

Women's experience of colposcopy: a qualitative investigation

Research article

Assisted Reproduction: What factors interfere in the professional's decisions? Are single women an issue?