Barriers and Self-Control-Experiences of Using a Female Condom among Brothel-Based Female Sex Workers in a Western Indian City: A Qualitative Study

Background and Objectives: Female Condom (FC) is a dual protection contraceptive, aimed both, towards the prevention of pregnancyas well as STIs/HIV in women. The National AIDS Control Programme, implemented by the State agency, therefore seeks to popularize its acceptance and usage among Female Sex Workers (FSWs), as an option to male condoms, to adopt safe sex with clients and to reduce the incidence of STIs/HIV. The objective of this study was to document the knowledge and first hand experiences of FC use amongst brothel based Female Sex Workers (FSWs) of a city in western India. Methods: The study is a subsection of a mixed methods doctoral study. The data was extracted from qualitative design. In-depth interviews with FSWs were administered. FSWs were selected from the brothels using a purposive sampling method. A total of twenty in depth interviews were administered. Interpretations: The study reflected the advantages and limitations of the use of FC. The FSWs were found to have low knowledge about FC. In some instances such as dealing in ebriated clients and in intimate relations, the FSWs thought that, it gave self-control to protect from unsafe encounters. But the cost attached to it as compared to the availability of free male condoms, different serious misconceptions including fear of FC getting trapped inside the vagina during use, increase time in client's ejaculation were challenges in use. Conclusion: The study reveals the positives and challenges experienced in using FC among brothel based FSWs. There is a need to strengthen the promotion of usage of FCs in FSWs through the Targeted Interventions (TI) of National AIDS Control Organization (NACO) to improve the knowledge and to reduce different road blocks that would impede the use of FCs among FSWs.