Protection and participation: an interactive programme introducing the female condom to migrant sex workers in Cambodia

Abstract

The female condom has received much attention for its potential to empower users in negotiating safer sex. Studies demonstrate that the process used to introduce the method can influence subsequent use rates, resulting in calls for comprehensive documentation of introduction activities. This paper details an intervention study introducing the female condom to Vietnamese sex workers in Cambodia. Part of a wider community mobilization approach to reducing HIV/AIDS transmission, the intervention emphasized informed debate, group skills building and collective support. Research methods included both quantitative and qualitative data collection to evaluate the introduction's effect on sex workers’ negotiation skills and social support networks. The findings show that approximately 16% of sex workers tried the female condom. Ever-use was significantly associated with participation in intervention workshops, and with indicators of both individual and community empowerment. Sex workers who incorporated the female condom into their work were also more likely to feel a sense of community identity. Introduced through an appropriate process, the female condom can serve as an ‘entry point’ to building community capacity. It can support sex workers in achieving protected sex and developing cooperative relationships, even in severely restrictive settings.

Acknowledgments

This study was supported by the Population Council's Horizons Project. The Horizons Project is funded by the US Agency for International Development, Office of Health, HIV/AIDS Division, Co-operative Agreement HRN-A-00-97-00012-00, Global Leadership, Research, and Development Responsibilities and Best Practices in HIV/AIDS. The following non-governmental organisations contributed to implementation of the project: Population Council/Horizons, Medecins Sans Frontieres (Belgium/Holland/Switzerland), Cambodian Researchers for Development, and Khemera.