In the sex industry

In the sex industry
Experience throughout the developing world confirms that the greatest changes in
sexual behaviour have taken place among sex workers and their clients. Thailand’s
100% Condom Use Programme achieved nearly universal use of condoms in its large
sex industry. After an intensive campaign of condom promotion and distribution in
brothels, a survey found that the proportion of female sex workers who said that they
always use condoms during commercial sex rose from 14% in 1989 to over 90% in
1994 32,33. Another study found that consistent condom use among brothel-based sex
workers went up from 87% in 1993 to 97% in 1996 34.
Evaluations of HIV programmes and randomized trials in various parts of the world
reveal that some of the most effective prevention programmes have taken place in
sex-worker settings. Post-intervention in a randomized trial in Mumbai, India, 70%
of women reported using condoms at least sometimes and 28% said they used them
always. These proportions compared to 53% and 0% respectively for women in control
brothels who did not receive the intervention. HIV incidence was 5% per year in the
intervention group, versus 16% per year in the control group, with similar differences
in the incidence of other STIs 35. In the Democratic Republic of the Congo in 1994, an
HIV-prevention programme for sex workers increased consistent condom use from
11% to 68% and decreased HIV incidence from 11.7% per year to 4.4% per year, with
parallel decreases in other STIs 36. In Senegal in 1999, 94% of sex workers reported
using a condom the last time they had sex with a regular client and 98% with a new
client 37. In Kampala, Uganda, in 2001, 99% of female sex workers reported using a
condom when they last had intercourse 38. Unfortunately, these success stories are by
no means typical of all parts of the developing world. Nevertheless, they demonstrate
that very high rates of condom use in commercial sex are achievable.