What’s in a name? A mixed method study on how young women who sell sex characterise male partners and their use of condoms

Busza, Joanna, Hensen, Bernadette, Birdthistle, Isolde, Chabata, Sungai T, Hargreaves, James R, Floyd, Sian, Chiyaka, Tarisai, Mushati, Phillis and Cowan, Frances ORCID: https://orcid.org/0000-0003-3087-4422 (2021) 'What’s in a name? A mixed method study on how young women who sell sex characterise male partners and their use of condoms'. JAIDS: Journal of Acquired Immune Deficiency Syndromes, Vol 87, Issue 1, pp. 653-662.

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Abstract

ntroduction
Young women who sell sex (YWSS) are at disproportionate risk of HIV. Reducing YWSS’ vulnerability requires engaging their male sexual partners. To achieve this, we need to understand the characteristics and dynamics of their sexual partnerships to inform effective interventions.

Methods
We conducted a mixed methods study to compare YWSS’ qualitative descriptions of male partners with categories reported in a behavioural survey. Data were drawn from enrolment into an evaluation of the DREAMS initiative in Zimbabwe in 2017. As part of a respondent-driven sampling survey, we recruited 40 seed participants from 2 intervention and 4 comparison sites. We conducted semi-structured interviews with 19 “seeds” followed by a behavioural survey with 2387 YWSS. We interpreted quantitative and qualitative data together to understand how YWSS perceived male sexual partners, assess how well survey variables related to narrative descriptions, and describe patterns of risk behaviour within partnerships.

Results
Qualitative data suggest survey categories “husband” and “client” reflect YWSS’ perceptions but “regular partner/boyfriend” and “casual partner” do not. In interviews, use of the term “boyfriend” was common, describing diverse relationships with mixed emotional and financial benefits. Over 85% of male partners provided money to YWSS, but women were less likely to report condom-less sex with clients than regular partners (11% vs 37%) and more likely to report condom-less sex with partners who ever forced them to have sex (37% vs 21%).

Conclusions
Reducing HIV risk among YWSS requires prevention messages and tools that recognise diverse and changing vulnerability within and between sexual relationships with different male partners.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.6 Prevention and control WP Gynecology > Contraception > WP 640 Contraceptive devices (General and female)
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1097/QAI.0000000000002623
Depositing User:	Stacy Murtagh
Date Deposited:	11 Mar 2021 12:12
Last Modified:	06 Apr 2021 12:39
URI:	https://archive.lstmed.ac.uk/id/eprint/17239

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