SEXUAL PRACTICES, THEIR INFLUENCERS AND UTILIZATION OF HIV SERVICES AMONG FEMALE SEX WORKERS IN MOMBASA COUNTY, KENYA

Abstract

Female sex workers (FSWs) are vulnerable to acquiring HIV and other sexually transmitted infections due to risky sexual practices. Risky sexual practices refer to sexual acts and behaviours that increase the chances of contracting and transmitting sexually transmitted infections. Understanding and addressing the gaps in safer sexual practices among FSWs can help to reduce HIV acquisition and transmission. This study focused on the sexual practices, their determinants, HIV knowledge, and use of HIV testing services among FSWs in Mombasa County, Kenya. Cross-sectional research design was adopted in the investigation. Respondents were recruited by systematic random selection at predetermined intervals from bars and clubs until a sample size of 160 was reached. Women who were above 18 years and had in the past exchanged goods or money for sex were referred to as female sex workers. Descriptive statistics and inferential analysis using R was done and p<0.05 was regarded statistically significant. Ethical approval and clearance were obtained from the Kenyatta National Hospital and University of Nairobi Ethics Review Committee. Informed consent was obtained from participants prior to the interviews. Most of the participants (98.74%) were unmarried, 97.48% reported vaginal intercourse, 50.96% reported using alcohol before sex and 10.69% had a tertiary education. Risky sex was practiced by 27.67% of study participants. Slightly more than a half (64.15%) had tested for HIV within three months, 13.84% believed that it is safe to reuse condoms and 10.06% that it is safe engaging in unprotected sex. Risky sexual practices in bi-variate analysis were associated with frequency of sexual intercourse, frequency of vaginal intercourse, alcohol use, violence and poor HIV knowledge. In multivariate analysis, risky sexual practices were associated with frequency of sexual intercourse, alcohol use and poor HIV knowledge. Female sex workers are still engaging in unprotected sex while intoxicated, belief in re-using condoms and high frequency of sexual intercourse. Alcohol use significantly correlates to risky sexual practices. Few FSWs test for HIV within three months and some still has poor knowledge about HIV. Interventions to address these modifiable factors such as promoting partners’ conversations about condom use, routine alcohol use risk reduction counselling and creating FSWs social networks are needed.