Love moderates the relationship between partner type and condom use among women engaging in transactional vaginal sex
Alexis M. Roth A E , Joshua G. Rosenberger B , Devon J. Hensel C , Sarah E. Wiehe C , J. Dennis Fortenberry C and Karla D. Wagner D
+ Author Affiliations
- Author Affiliations
A Department of Community Health and Prevention, School of Public Health, Drexel University, Nesbitt Hall, 3215 Market Street, Philadelphia, Pennsylvania 19104, USA.
B Pennsylvania State University, 149 Biobehavioral Health Building, University Park, PA 16802, USA.
C Indiana University Purdue University Indianapolis, 410 W. 10th Street, Indianapolis, IN 46202, USA.
D University of Nevada, 1664 N. Virginia Street MS 0274, Reno, NV 89557-0274, USA.
E Corresponding author. Email: amr395@drexel.edu
Sexual Health 13(2) 170-176 https://doi.org/10.1071/SH15167
Submitted: 22 August 2015 Accepted: 15 October 2015 Published: 30 November 2015
Abstract
Background: Relationship characteristics and day-to-day variation in affective state have been associated with HIV risk behaviour. However, no research has assessed the impact of these factors on event-level condom use among women engaging in transactional sex. Methods: Twenty-six women engaging in transactional sex were enrolled in a prospective study of their sexual health. They completed diaries about multi-level predictors of condom use during vaginal sex twice, daily. Results: Over 4 weeks, 18 participants reported 87 paid/traded vaginal intercourse events. Of these, 51.7% were condom protected. The majority of paid/traded events (81.5%) occurred with a non-romantic partner. After controlling for partner type, feeling in love on a given day was associated with higher odds of condom use during paid/traded sexual events, while having sex on the weekend and at night were associated with lower odds of condom use (all P ≤ 0.05). There was a significant interaction between being in love and using condoms during transactional sex (P < 0.01). In paid/traded sexual events with romantic partners, the frequency of condom use was 71.4% (5/7) when women did not report love and 40% (4/10) when love was reported. In sexual events with non-romantic partners, the frequency of condom use was 43.8% (14/32) when women did not report love and 59.5% (22/37) when love was reported. Conclusions: Women were less likely to report protected sex with romantic partners and more likely to report protected sex with non-romantic partners when they are in love. Interventions focusing on the link between day-to-day variation in affective state on condom use may help women with risk management across partner types.
Additional keywords: condoms, diary, event-analysis, transactional sex.
References
[1] Bobashev GV, Zule WA, Osilla KC, et al Transactional sex among men and women in the south at high risk for HIV and other STIs. J Urban Health 2009; 86 32–47.| Transactional sex among men and women in the south at high risk for HIV and other STIs.Crossref | GoogleScholarGoogle Scholar | 19513853PubMed |
[2] Mc Grath-Lone L, Marsh K, Hughes G, et al The sexual health of female sex workers compared with other women in England: analysis of cross-sectional data from genitourinary medicine clinics. Sex Transm Infect 2014; 90 344–50.
| The sexual health of female sex workers compared with other women in England: analysis of cross-sectional data from genitourinary medicine clinics.Crossref | GoogleScholarGoogle Scholar | 24493858PubMed |
[3] Linhart Y, Shohat T, Amitai Z, et al Sexually transmitted infections among brothel-based sex workers in Tel-Aviv area, Israel: high prevalence of pharyngeal gonorrhoea. Int J STD AIDS 2008; 19 656–9.
| Sexually transmitted infections among brothel-based sex workers in Tel-Aviv area, Israel: high prevalence of pharyngeal gonorrhoea.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1cnjtlGrsw%3D%3D&md5=f5e38ee6964db973e2e451e489a281fcCAS | 18824615PubMed |
[4] Campos PE, Buffardi AL, Cárcamo CP, et al Reaching the unreachable: providing STI control services to female sex workers via mobile team outreach. PLoS One 2013; 8 e81041
| Reaching the unreachable: providing STI control services to female sex workers via mobile team outreach.Crossref | GoogleScholarGoogle Scholar | 24282565PubMed |
[5] Jones DL, Irwin KL, Inciardi J, et al The high-risk sexual practices of crack-smoking sex workers recruited from the streets of three American cities. Sex Transm Dis 1998; 25 187–93.
| The high-risk sexual practices of crack-smoking sex workers recruited from the streets of three American cities.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3isF2jug%3D%3D&md5=88f06021a8494f0aa33e9a989db11068CAS | 9564720PubMed |
[6] McMahon JM, Tortu S, Pouget ER, et al Contextual determinants of condom use among female sex exchangers in East Harlem, NYC: an event analysis. AIDS Behav 2006; 10 731–41.
| Contextual determinants of condom use among female sex exchangers in East Harlem, NYC: an event analysis.Crossref | GoogleScholarGoogle Scholar | 16779657PubMed |
[7] Surratt HL, Kurtz SP, Weaver JC, et al The connections of mental health problems, violent life experiences, and the social milieu of the “Stroll” with the HIV risk behaviors of female street sex workers. J Psychol Human Sex 2005; 17 23–44.
| The connections of mental health problems, violent life experiences, and the social milieu of the “Stroll” with the HIV risk behaviors of female street sex workers.Crossref | GoogleScholarGoogle Scholar |
[8] Surratt HL, Inciardi JA, Kurtz SP, et al Sex work and drug use in a subculture of violence. Crime Delinq 2004; 50 43–59.
| Sex work and drug use in a subculture of violence.Crossref | GoogleScholarGoogle Scholar |
[9] May J, Cloke P, Johnsen S. Alternative cartographies of homelessness: rendering visible British women’s experience of ‘visible’ homelessness. Gend Place Cult 2007; 14 121–40.
| Alternative cartographies of homelessness: rendering visible British women’s experience of ‘visible’ homelessness.Crossref | GoogleScholarGoogle Scholar |
[10] Thomas JC, Tucker MJ. The development and use of the concept of a sexually transmitted disease core. J Infect Dis 1996; 174 S134–43.
| The development and use of the concept of a sexually transmitted disease core.Crossref | GoogleScholarGoogle Scholar | 8843243PubMed |
[11] Jennings JM, Curriero FC, Celentano D, et al Geographic identification of high gonorrhea transmission areas in Baltimore, Maryland. Am J Epidemiol 2005; 161 73–80.
| Geographic identification of high gonorrhea transmission areas in Baltimore, Maryland.Crossref | GoogleScholarGoogle Scholar | 15615917PubMed |
[12] Shahmanesh M, Gayed S, Ashcroft M, et al Geomapping of chlamydia and gonorrhoea in Birmingham. Sex Transm Infect 2000; 76 268–72.
| Geomapping of chlamydia and gonorrhoea in Birmingham.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvns1yisw%3D%3D&md5=a963cc9e25fde0afa60edf844d5adc5bCAS | 11026881PubMed |
[13] Shannon K, Kerr T, Bright V, et al Drug sharing with clients as a risk marker for increased violence and sexual and drug-related harms among survival sex workers. AIDS Care 2008; 20 228–34.
| Drug sharing with clients as a risk marker for increased violence and sexual and drug-related harms among survival sex workers.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c7jtlSqug%3D%3D&md5=21ed3ba3edae1740a8b956ebf6dbb5cbCAS | 18293134PubMed |
[14] Fichtenberg CM, Jennings JM, Glass TA, et al Neighborhood socioeconomic environment and sexual network position. J Urban Health 2010; 87 225–35.
| Neighborhood socioeconomic environment and sexual network position.Crossref | GoogleScholarGoogle Scholar | 20140533PubMed |
[15] Fichtenberg CM, Muth SQ, Brown B, et al Sexual network structure among a household sample of urban African American adolescents in an endemic sexually transmitted infection setting. Sex Transm Dis 2009; 36 41–8.
| Sexual network structure among a household sample of urban African American adolescents in an endemic sexually transmitted infection setting.Crossref | GoogleScholarGoogle Scholar | 18830136PubMed |
[16] Syvertsen JL, Robertson AM, Palinkas LA, et al Where sex ends and emotions begin: love and HIV risk among female sex workers and their intimate, non-commercial partners along the Mexico-U.S. Border. Cult Health Sex 2013; 15 540–54.
| Where sex ends and emotions begin: love and HIV risk among female sex workers and their intimate, non-commercial partners along the Mexico-U.S. Border.Crossref | GoogleScholarGoogle Scholar | 23473586PubMed |
[17] Jackson LA, Augusta-Scott T, Burwash-Brennan M, et al Intimate relationships and women involved in the sex trade: perceptions and experiences of inclusion and exclusion. Health 2009; 13 25–46.
| Intimate relationships and women involved in the sex trade: perceptions and experiences of inclusion and exclusion.Crossref | GoogleScholarGoogle Scholar | 19103714PubMed |
[18] Varga CA. The condom conundrum: barriers to condom use among commercial sex workers in Durban, South Africa. Afr J Reprod Health 1997; 1 74–88.
| The condom conundrum: barriers to condom use among commercial sex workers in Durban, South Africa.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M3jtFShsg%3D%3D&md5=f689acbe9fdb5bf2989440731ff79114CAS | 10214405PubMed |
[19] Sanders T. The condom as psychological barrier: Female sex workers and emotional management. Fem Psychol 2002; 12 561–6.
| The condom as psychological barrier: Female sex workers and emotional management.Crossref | GoogleScholarGoogle Scholar |
[20] Luchters S, Richter ML, Bosire W, et al The contribution of emotional partners to sexual risk taking and violence among female sex workers in Mombasa, Kenya: a cohort study. PLoS One 2013; 8 e68855
| The contribution of emotional partners to sexual risk taking and violence among female sex workers in Mombasa, Kenya: a cohort study.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhtlWgt7nI&md5=8ee0d40bd899e7b641e32bf5a2c2a6eeCAS | 23950879PubMed |
[21] Wang C, Hawes SE, Gaye A, et al HIV prevalence, previous HIV testing, and condom use with clients and regular partners among Senegalese commercial sex workers. Sex Transm Infect 2007; 83 534–40.
| HIV prevalence, previous HIV testing, and condom use with clients and regular partners among Senegalese commercial sex workers.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2snosVCmtQ%3D%3D&md5=ad6ee6e56f65018bdc32b9d0f453627dCAS | 17942575PubMed |
[22] Maher L, Mooney-Somers J, Phlong P, et al Condom negotiation across different relationship types by young women engaged in sex work in Phnom Penh, Cambodia. Glob Public Health 2013; 8 270–83.
| Condom negotiation across different relationship types by young women engaged in sex work in Phnom Penh, Cambodia.Crossref | GoogleScholarGoogle Scholar | 23432108PubMed |
[23] Robertson AM, Syvertsen JL, Amaro H, et al Can’t buy my love: a typology of female sex workers’ commercial relationships in the Mexico–U.S. border region. J Sex Res 2013; 51 711–20.
| 23659340PubMed |
[24] Stoebenau K, Hindin MJ, Nathanson CA, et al “… but then he became my Sipa”: the implications of relationship fluidity for condom use among women sex workers in Antananarivo, Madagascar. Am J Public Health 2009; 99 811–9.
| “… but then he became my Sipa”: the implications of relationship fluidity for condom use among women sex workers in Antananarivo, Madagascar.Crossref | GoogleScholarGoogle Scholar | 19299685PubMed |
[25] Hensel DJ, Fortenberry JD, Orr DP. Factors associated with event level anal sex and condom use during anal sex among adolescent women. J Adolesc Health 2010; 46 232–7.
| Factors associated with event level anal sex and condom use during anal sex among adolescent women.Crossref | GoogleScholarGoogle Scholar | 20159499PubMed |
[26] Sprecher S. Sexual satisfaction in premarital relationships: associations with satisfaction, love, commitment, and stability. J Sex Res 2002; 39 190–6.
| Sexual satisfaction in premarital relationships: associations with satisfaction, love, commitment, and stability.Crossref | GoogleScholarGoogle Scholar | 12476266PubMed |
[27] Morrison C-A. Solicited diaries and the everyday geographies of heterosexual love and home: reflections on methodological process and practice. Area 2012; 44 68–75.
| Solicited diaries and the everyday geographies of heterosexual love and home: reflections on methodological process and practice.Crossref | GoogleScholarGoogle Scholar |
[28] Rosenberger J, Herbenick D, Novak D, et al What’s love got to do with it? Examinations of emotional perceptions and sexual behaviors among gay and bisexual men in the United States. Arch Sex Behav 2014; 43 119–28.
| What’s love got to do with it? Examinations of emotional perceptions and sexual behaviors among gay and bisexual men in the United States.Crossref | GoogleScholarGoogle Scholar | 24287965PubMed |
[29] Tanner AE, Hensel DJ, Fortenberry JD. A prospective study of the sexual, emotional, and behavioral correlates associated with young women’s first and usual coital events. J Adolesc Health 2010; 47 20–5.
| A prospective study of the sexual, emotional, and behavioral correlates associated with young women’s first and usual coital events.Crossref | GoogleScholarGoogle Scholar | 20547288PubMed |
[30] U.S. Census Bureau. State & county quickfacts: Marion County, Indiana. Available online at: http://quickfacts.census.gov/qfd/states/18/18097.html [verified 10 October 2015].
[31] Marion County Health Department. Marion County syphilis elimination plan for 2000. Available online at: http://www.mchd.com/Syphilis/MCHDSE/MCSEP.html [verified 10 October 2015].
[32] Marion County Health Department. Communicable diseases report 2002–2005. Available online at: http://www.mchd.com/data_reports/mccha/09_Communicable_Diseases.html [verified 10 October 2015].
[33] Marion County Health Department. Syphilis outbreak confirmed in Marion County 2008. Available online at: http://www.mchd.com/Syphilis/2008/pdf/pr_040408.pdf [verified 10 October 2015].
[34] Roth A, Hensel D, Fortenberry JD, Garfein R, Gunn JL, Wiehe S. Feasibility and acceptability of cell phone diaries to measure HIV risk behavior among female sex workers. AIDS Behav 2014; 2014 1–11.
[35] Hensel DJ, Fortenberry JD, Harezlak J, Craig D. The feasibility of cell phone based electronic diaries for STI/HIV research. BMC Med Res Methodol 2012; 12 75–86.
| The feasibility of cell phone based electronic diaries for STI/HIV research.Crossref | GoogleScholarGoogle Scholar | 22691189PubMed |
[36] Zeger SL, Liang K-Y, Albert PS. Models for longitudinal data: a generalized estimating equation approach. Biometrics 1988; 44 1049–60.
| Models for longitudinal data: a generalized estimating equation approach.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL1M7ms1Onuw%3D%3D&md5=0d00d0f3de33148930ed0634e3d2f4d4CAS | 3233245PubMed |
[37] IBM Corp. IBM SPSS Statistics for Windows. Released 2013. Chicage: IBM Corp.
[38] Kippax S, Noble J, Prestage G, Crawford JM, Campbell D, Baxter D, et al Sexual negotiation in the AIDS era: negotiated safety revisited. AIDS 1997; 11 191–7.
| Sexual negotiation in the AIDS era: negotiated safety revisited.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s7ot1ehtA%3D%3D&md5=d9eaa9e0163aea110b0d8bc3be037816CAS | 9030366PubMed |
[39] Corbett AM, Dickson-Gómez J, Hilario H, Weeks MR. A little thing called love: condom use in high-risk primary heterosexual relationships. Perspect Sex Reprod Health 2009; 41 218–24.
| A little thing called love: condom use in high-risk primary heterosexual relationships.Crossref | GoogleScholarGoogle Scholar | 20444176PubMed |
[40] Rhodes T, Cusick L. Love and intimacy in relationship risk management: HIV positive people and their sexual partners. Sociol Health Illn 2000; 22 1–26.
| Love and intimacy in relationship risk management: HIV positive people and their sexual partners.Crossref | GoogleScholarGoogle Scholar |
[41] Bluthenthal RN, Fehringer JA. Commentary on Li et al. A call for comprehensive approaches to sex-related human immunodeficiency virus risk among drug users. Addiction 2011; 106 1788–9.
| Commentary on Li et al. A call for comprehensive approaches to sex-related human immunodeficiency virus risk among drug users.Crossref | GoogleScholarGoogle Scholar |
