Department of Sociology and Anthropology, College of the Holy Cross, Worcester, MA, USA.
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA.
AIDS Behav. 2018 Feb;22(2):637-648. doi: 10.1007/s10461-017-1922-3.
We examined why male condoms broke or slipped off during commercial sex and the actions taken in response among 75 female and male sex workers and male clients recruited from 18 bars/nightclubs in Mombasa, Kenya. Most participants (61/75, 81%) had experienced at least one breakage or slippage during commercial sex. Many breakages were attributed to the direct actions of clients. Breakages and slippages fell into two main groups: those that were intentionally caused by clients and unintentional ones caused by inebriation, forceful thrusting during sex and incorrect or non-lubricant use. Participant responses included: stopping sex and replacing the damaged condoms, doing nothing, getting tested for HIV, using post-exposure prophylaxis and washing. Some sex workers also employed strategies to prevent the occurrence of condom breakages. Innovative client-oriented HIV prevention and risk-reduction interventions are therefore urgently needed. Additionally, sex workers should be equipped with skills to recognize and manage breakages.
我们研究了在肯尼亚蒙巴萨的 18 家酒吧/夜总会招募的 75 名性工作者和男性客户中，商业性行为期间安全套破裂或滑脱的原因，以及针对这些情况采取的措施。大多数参与者（61/75，81%）在商业性行为中至少经历过一次安全套破裂或滑脱。许多破裂是由于客户的直接行为造成的。破裂和滑脱分为两类：一类是客户故意造成的，另一类是由于醉酒、性行为时用力过猛以及使用不当或未使用润滑剂造成的非故意破裂。参与者的反应包括：停止性行为并更换破损的安全套、什么都不做、进行 HIV 检测、使用暴露后预防措施和清洗。一些性工作者还采取了一些策略来防止安全套破裂的发生。因此，迫切需要针对客户的创新性艾滋病毒预防和减少风险干预措施。此外，应该为性工作者提供识别和处理安全套破裂的技能。
