Exploratory study on condom use among sex workers and their clients in Yerevan

Abstract

Introduction: During the last decade the spread of sexually transmitted diseases (STDs) and the introduction of a new epidemic of Human Immune Deficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) has become a threat for the health of thousands of people in Armenia. The situation is complicated by increasing prostitution, lack of awareness on STDs among the population and the non-healthy behavior of sex workers (SWs) and their male clients. The research conducted here is intended to explore the influences on condom use among SWs and their clients in Yerevan. Methods: Different qualitative research methods were applied in the study. Four focus group interviews were conducted with the general male population in 18-45 age groups, four in- depth interviews with SWs and five key-informant interviews with experts in the Republican Medical-Scientific Center of Dermatology and STI during August-September 2001. Results: The obtained data suggests that SWs are more prone to use condoms than their male clients. The awareness of general male population on STDs isn’t very high, and they do not fully understand the risk of unsafe sex practices. There is a trend that older and/or married and/or men once infected with STD are more cautious compared to the younger ones. And there is another trend that older SWs and/or higher class and/or SW once infected with STD are more inclined to use condoms than just out SWs. The main reason that SWs aren’t using condoms is client resistance. The reasons why males do not use condoms are reduction of pleasure, fear of suggesting condom-use, difficulty to climax, and alcohol abuse. Recommendations: The study could be expanded to the marzes of Armenia. It is suggested to conduct a survey among general male population on their knowledge, attitude and practices on condom use on the basis of these qualitative research findings. School sex education is suggested to develop the proper understanding and sound thinking with regards to safe sex practices and STDs from early ages. The findings of this study should be presented to interested donor organizations to encourage implementation of appropriate educational campaign in the schools. Legalization of prostitution was not found to be acceptable at this time in Armenia.