Recorded presentation

Elyse Levine, PhD, Consultant, Ave. la Capilla #559, Casa #9, San Salvador, El Salvador, +503 243-6443, elevine@integra.com.sv

Background: PASMO Central America operates sustainable and effective condom social marketing programs, targeting vulnerable groups such as commercial sex workers (CSW) and men who have sex with men (MSM). Focus group research was commissioned to learn more about the dynamics and context of sexual behavior in these key populations. Methods: Focus groups were conducted with: CSWs ambulatory and non-ambulatory who use condoms, and comparable groups of CSWs who do not use condoms; MSM who use condoms, and a comparable group who do not use condoms; bisexuals; transvestites; male commercial sex workers. Results: Despite generally sound knowledge of HIV transmission and prevention, and despite positive attitudes toward condom use, most participants reported inconsistent use of contraceptives. Among CSWs, economic necessity was most frequently cited as the reason for not using condoms with clients. The women also tend to have unprotected sex with their regular partners, even though many fear that their partners' infidelity puts them at risk for STDs. The sub-groups of MSM expressed varied reasons for not using condoms including: perceived fidelity of their partners; influence of drugs or alcohol; inconvenience "when opportunity strikes"; and hedonistic factors ("it doesn't feel the same"). A minority of female and male sex workers routinely negotiate condom use with clients, but several reported violent confrontations when clients refused to use protection. Conclusions: Programs encouraging consistent use of condoms must address real and perceived barriers among vulnerable populations. The use of models such as Stages of Change may facilitate more consistent use of condoms.

Learning Objectives: At the conclusion of the session, participants will be able to

• Describe factors affecting condom use by different segments of female commercial sex workers and men who have sex with men.
• Discuss the necessity for specific interventions for different sub-groups.
• Contemplate applications of theory-based models to encourage safer sex practices in these vulnerable groups.

Keywords: HIV Risk Behavior, Vulnerable Populations

Related Web page: www.psi.org/

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation