Pablo K. Valente,1,2 Joanne E. Mantell,2,* Tsitsi B. Masvawure,3 Jack Ume Tocco,2 Arjee J. Restar,1,2 Peter Gichangi,4,5,6 Sophie Vusha Chabeda,4 Yves Lafort,5 and Theo G. Sandfort2
Affiliations
1Brown University, Brown School of Public Health, Brown University, Providence, Rhode Island.
2HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY.
3Department of Sociology and Anthropology, College of the Holy Cross, Worcester, MA
4International Centre for Reproductive Health-Kenya, Mombasa, Kenya.
5International Centre for Reproductive Health-Ghent University, Ghent, Belgium.
6Department of Anatomy, University of Nairobi, Kenya.
*Corresponding Author: Joanne E. Mantell, MS, MSPH, PhD; HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, USA; 1051 Riverside Drive, Unit 15, New York, NY 10032; Tel: +1 646-774-6951; ude.aibmuloc.cmuc@75mej (JEM).
Abstract
Male sex workers in Kenya face a disproportionate burden of HIV and often engage in condomless sex with their commercial partners, yet little is known about how condom negotiations between male sex workers and clients take place. We conducted semi-structured interviews with 25 male sex workers and 11 male clients of male sex workers in Mombasa, Kenya, to examine barriers and facilitators to condom use and how condom negotiation takes place in these interactions. Participants reported positive attitudes toward condom use and perceived condom use to be a health-promoting behavior. Barriers to condom use included extra-payment for condomless sex, low perceived HIV/STI risk with some sexual partners, perceived reduced pleasure associated with using condoms, alcohol use, and client-based violence against male sex workers. Future interventions should address individual- and structural-level barriers to condom use to promote effective condom negotiation in interactions between male sex workers and male clients.
Keywords: Men who have sex with men, Male sex work, Condom negotiations, HIV/AIDS, HIV prevention, Kenya
Palabras clave: HSH, Hombres trabajadores sexuales, Negociación para el uso del condón, VIH, Prevención del VIH, Kenia
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