Condom use negotiation among sex workers in Singapore: findings from qualitative research.
Following an earlier study of 806 sex workers in Singapore in which they were found to succeed only half the time in getting clients to use condoms, a qualitative investigation was conducted on 40 sex workers to explore their perceived barriers and approaches in negotiating condom use with clients.  Five different patterns of condom use were identified:  successful, unsuccessful, misinformed, passive and uninterested.  The successful negotiators used several practical approaches to secure clients' compliance.  Unsuccessful negotiators experienced problems such as inability to resist clients' pressure or respond to their queries. The misinformed group believed that regular clients were safe.  The passive group did not negotiate condom use due to their perceptions of lack of support from peers and brothel keepers, and the uninterested group was apathetic with fatalistic perceptions of AIDS.  The in-depth interviews with successful negotiators provided relevant, specific and practical information which could be disseminated to their peers to develop their negotiation skills.  This qualitative study also provided useful insights on condom use negotiation and highlighted the need for comprehensive interventions which should not only aim at developing sex workers' negotiation skills but also at gathering support from brothel keepers to facilitate behaviour change, and public education directed at clients to increase condom use.
Department of Community, Occupational and Family Medicine National University of Singapore, National University Hospital.
M L
ML
Wong
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C
Archibald
K W
KW
Roy
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A
Goh
T C
TC
Tan
C L
CL
Goh
D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009042:Motivation; D017008:Negotiating; D011477:Sex Work; D012846:Singapore