ArticleBMC public health2025
Condomless sexual encounters among female sex workers included in a longitudinal coital diary study in Zimbabwe.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- HIV Prevalence, Virological Suppression, and Consistent Condom Use Among Social Venue-Going Men in Zimbabwe: Insights from the 2022 Priorities for Local AIDS Control Efforts (PLACE) Surveys.AIDS and behavior · 2026Article
- Exploring the contribution of self-help groups to sexual and reproductive health and HIV outcomes for female sex workers in sub-Saharan Africa: A scoping review.PLOS global public health · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundCompared with the general female population, female sex workers (FSWs) experience a greater burden of STIs, including HIV. Consistent condom use reduces HIV risk; however, while many FSWs are aware of condom efficacy, this knowledge does not consistently translate into use. We aimed to estimate the prevalence and patterns of condomless sex by partner type at the sexual encounter level, as well as identify factors associated with condomless sex among FSWs recruited into a diary study in Zimbabwe.
methodsWe conducted a longitudinal coital diary study in site A and site B between 25 November 2020 and 30 December 2021. Pictorial diaries were developed in collaboration with FSWs. We recruited participants using snowball sampling and asked them to complete a daily diary of their sexual encounters with each partner for one month, repeated over three non-consecutive months within 12 months. The following FSW characteristics were recorded: FSW age, Key Populations (KP) Programme contact, partner type and age, condom use categorized as none, partial, or full, types of sexual activity, and violence experiences. To identify factors associated with condomless sex, we used hierarchical Poisson regression modelling.
results404 FSWs documented 62,559 sex encounters, with 17,325 (27.7%) reported as condomless. Our adjusted analysis showed that encounters with permanent partners had the highest likelihood of being condomless (59.5%; adjusted relative risk [aRR] 3.83, 95% CI: 3.38-4.35), followed by regular partners (25.6%; aRR 1.63, 95% CI: 1.50-1.78), compared to new partners (15.0%). Compared with FSWs aged < 25 years (29.7%), those aged ≥ 35 years were less likely to have condomless sex (22.1%; aRR 0.79, 95% CI: 0.66-0.94), while sex without violence was less likely (24.1%) to be condomless than sex with violence (57.7%; aRR 2.32, 95% CI: 2.00-2.70). FSWs with the KP programme contact reported fewer condomless encounters (25.9%; aRR 0.81, 95% CI: 0.90-0.94) than those without (32.9%).
conclusionCondomless sex was common and varied based on FSW age, partner type, experiencing violence during sex, and KP programme contact. These findings emphasize the need for continued condom promotion, counseling, violence mitigation, and training in condom negotiation skills especially given the heightened risk of HIV transmission among FSWs.
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