Condom use by prostitutes: behavior,factors and considerations

119 female prostitutes were interviewed over the period July 1990-March 1991 about their sex behavior and condom use, their working attitude, and perception of risk in an attempt to combine qualitative and quantitative research methods to gain insight into the determinants of condom use in prostitution by putting high or low risk taking behavior into context. The participants were recruited from different regions of the Netherlands, of mean age 29.8 years, and had been working in the field for an average 6.8 years. Most of the 28% of participants who did not have Dutch nationality were from Germany or Latin America. Health locus of control and attributions concerning an unpleasant proceeding of client contacts were assessed by means of item lists. Prostitutes were identified as either consistent condom users, selective risk takers, or risk takers. Consistent condom users used condoms on all occasions, selective risk takers used condoms for vaginal sex with all but a few selected clients, and risk takers seeing no possibility of consistently getting clients to use a condom for vaginal sex used condoms the least frequently. 78% were consistent users, 11% were selective risk takers, and 11% were risk takers. Protection behavior was found to be linked to working attitude. Condom use is most likely among women with a moderately positive, yet businesslike, working attitude, and least likely among those with a negative working attitude and when there is no positive identification with the professional group. It appears that health locus of control is of no influence on protection style, but risk takers attribute an unpleasant proceeding of client contacts significantly more to powerlessness and helplessness. The authors conclude that the objective situation of women influences condom use at least as strongly as subjective motivations.