HIV This Week

Ntumbanzondo M, Dubrow R, Niccolai LM, Mwandagalirwa K, Merson MH. Unprotected intercourse for extra money among commercial sex workers in Kinshasa, Democratic Republic of Congo. AIDS Care 2006;18:777-85.

Nturnbanzado and colleagues assessed the extent and correlates of the practice of engaging in unprotected intercourse for extra money among sex workers in Kinshasa, Democratic Republic of the Congo. The authors conducted a cross-sectional survey using a structured, interviewer-administered questionnaire among a convenience sample of 136 sex workers. More than one-quarter of sex workers (26.5%) engaged in unprotected intercourse for extra money. These sex workers charged about 3.5 times more for unprotected intercourse than for protected intercourse. Multivariate logistic regression showed that sex workers who engaged in unprotected intercourse for extra money were significantly more likely to live or work in non-downtown (lower socioeconomic) areas of Kinshasa (odds ratio [OR] = 3.07), to have at least one child less than six years of age (OR = 2.95), and to know other sex workers who engaged in the same practice (OR = 9.38). We hypothesize that desperate socioeconomic conditions combined with peer/social norms drive the practice of engaging in unprotected intercourse for extra money. Additional circumstances under which Kinshasa sex workers engaged in unprotected intercourse included intercourse with clients who tore their condoms to increase sexual pleasure (58.8% of sex workers), episodes of condom failure (56.8% of sex workers), and unprotected intercourse with regular noncommercial partners (only 5.3% of sex workers with noncommercial partners always used condoms with these partners).

Editors’ notes: These findings reflect the desperate socioeconomic situations of these sex workers and highlight the need to address poverty and other underlying determinants in HIV prevention programming.