Clients of female sex workers in Nyanza Province, Kenya: a core group in STD/HIV transmission

Abstract

Background: Commercial sex plays an important role in the spread of HIV and AIDS in Africa, especially in beginning epidemics. Goal: The goal was to study the sociodemographic charac- teristics and sexual risk behavior of clients of female sex workers (FSWs) in Nyanza province, Kenya. Study Design: In the town of Kisumu and the rural districts Siaya and Bondo, male clients of FSWs were identified in bars, nightclubs, and lodges. An informal conversation was held with 64 clients. Results: The majority of clients were between 25 and 36 years old, were married, and had extramarital partners in addition to FSWs. Most clients had visited several (3–5) dif- ferent FSWs in the previous year, of whom at least 2 were in long-term, steady client–FSW relationships. Clients visited FSWs an average of once or twice a week. Most clients were not consistently using condoms with FSWs; the main reason given was that they “trusted” their steady FSWs. Conclusion: Commercial sex in Nyanza frequently involves multiple steady relationships instead of rapidly changing one- time contacts. Information, education, and communication (IEC) campaigns aimed at risk reduction in commercial sex should promote condom use in steady FSW– client relationships.