Client-perpetuated violence and condom failure among female sex workers in southwestern China

Objectives: This research examined factors associated with condom failure, i.e., slippage or breakage, among female sex workers (FSWs) in China. Special attention was paid to the association between client-perpetuated violence and condom failure. Methods: Two hundred FSWs were recruited for a community-based voluntary human immunodeficiency virus prevention project. Participants completed a face-to-face structured questionnaire that collected information on their sociodemographic characteristics, working conditions, experience of client-perpetuated violence, and sexual risk behavior. Results: The prevalence of condom slippage and condom breakage in the 3 months before the survey was reported at 36.2% and 34%, respectively, of all sexual contact in which a condom was used. The prevalence of client-perpetuated violence in the previous year was 68.4%. Logistic regression analysis showed that after adjusting for other factors, condom failure was significantly associated with drug use [adjusted odds ratios (aOR = 4.01)], condom use of coworkers (aOR = 0.39), and client-perpetuated violence [aOR = 2.30 (low violence vs. high violence)]. Conclusion: Condom failure is a common problem among FSWs, particularly drug-using sex workers and those who have experienced client-perpetuated violence. On the other hand, condom use of coworkers is negatively associated with condom failure.