在马拉维布兰太尔半城市地区，女性性工作者（FSWs）在避孕套失败后的行为。
Actions taken by female sex workers (FSWs) after condom failure in semi urban Blantyre, Malawi.
机构信息
Ekwendeni Mission Hospital, P.O. Box 19, Ekwendeni, Mzimba North, Malawi.
Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Chichiri, Private Bag 360, Blantyre, Malawi.
出版信息
BMC Womens Health. 2020 Dec 9;20(1):273. doi: 10.1186/s12905-020-01142-y.
BACKGROUND
Little is known about actions taken by female sex workers (FSWs) after male condom failure during male-female sexual intercourse. The objective of this study was to investigate the actions taken by FSWs after condom failure among FSWs in semi-urban, Blantyre in Malawi.
METHODS
A cross sectional, qualitative study was conducted among FSWs in Blantyre, Malawi between May and July 2019. Snowballing technique was used to recruit study participants in four purposively selected study sites. Focus group discussions and in-depth interviews were conducted by trained research assistants among 40 FSWs. Data were analyzed using thematic content analysis.
RESULTS
Study participants reported having taken different actions after condom failure. Out of 18 FSWs who experienced condom failure, 10 reported to have stopped sex immediately and changed the condom and then resumed afterwards. They reported to have douched, urinated, and/or squatted to prevent pregnancy, sexually transmitted infections (STIs) and HIV acquisition. Five study participants reported to have asked for extra pay from the client; 10 FSWs didn't seek medical care. They thought the actions taken were enough for HIV and pregnancy prevention. Out of the 18 FSWs, only 3 stopped sexual intercourse completely and sought medical care which included post-exposure prophylaxis for HIV, STI treatment, and emergency contraceptives. Another 3 reported that they did not stop the sexual intercourse but only squatted and/or douched after sexual intercourse. The remaining 2 FSWs reported not to have stopped sexual intercourse and no any other actions were taken after the condom failure.
CONCLUSION
We report some inadequate behaviors among FSWs after condom failure. Health programs should develop interventions and support the performance of safer sex and actions after condom failure among FSWs to prevent STIs including HIV, and unplanned pregnancies. Interpersonal, structural and policy factors hindering FSWs' access to perform effective interventions need to be addressed.
背景
对于女性性工作者（FSW）在男女性交过程中避孕套破裂后的行为知之甚少。本研究的目的是调查马拉维布兰太尔半城市地区 FSW 避孕套破裂后的行为。
方法
2019 年 5 月至 7 月期间，在马拉维布兰太尔进行了一项横断面、定性研究。采用滚雪球技术在四个有针对性选择的研究地点招募研究参与者。经过培训的研究助理对 40 名 FSW 进行了焦点小组讨论和深入访谈。使用主题内容分析对数据进行分析。
结果
研究参与者报告在避孕套破裂后采取了不同的行动。在 18 名经历过避孕套破裂的 FSW 中，有 10 名报告立即停止性行为并更换避孕套，然后恢复性行为。他们报告说已经冲洗、排尿和/或蹲下以防止怀孕、性传播感染（STI）和 HIV 感染。有 5 名研究参与者报告向客户要求额外报酬；10 名 FSW 没有寻求医疗照顾。他们认为采取的行动足以预防 HIV 和怀孕。在 18 名 FSW 中，只有 3 人完全停止性交并寻求医疗保健，包括 HIV 暴露后预防、性传播感染治疗和紧急避孕药。另外 3 人报告说他们没有停止性行为，但只是在性交后蹲下和/或冲洗。其余 2 名 FSW 报告说他们没有停止性行为，并且在避孕套破裂后没有采取任何其他行动。
结论
我们报告了 FSW 在避孕套破裂后的一些不当行为。卫生项目应制定干预措施，并支持 FSW 在避孕套破裂后进行更安全的性行为和采取行动，以预防包括 HIV 在内的性传播感染和意外怀孕。需要解决阻碍 FSW 获得有效干预措施的人际、结构和政策因素。
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