P717 Using ethnography for planning and improving the quality of HIV prevention interventions for female sex workers in nigeria

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Background Female Sex Workers (FSW) and their clients account for half of HIV infections among key populations (KP) in Nigeria. The aim of this study was to better understand sexual behavior patterns and influences related to HIV vulnerability among men and women in venues that facilitates sexual networks in Nigeria as it relates to sex work. Methods A qualitative approach was employed using participant observations and face-to-face in-depth key informant interviews. Community ethnographers collected information from FSWs, clients of FSWs and key venue staff at venues where FSWs solicited clients. A semi-structured tool guided the interviews and questions explored how connections occur for the sale of sex and probed the power dynamics within connections. Results In all, 25 women and 25 men were interviewed. The in-depth interviews describe bar staff as vital players in the sex trade who provide financial and security services for FSWs. In exchange for these services FSWs are expected to pay with cash, commodities or sex. Majority of FSWs experienced violence from clients and law enforcement agents. Interviews indicate that there was a lack of governmental or non-governmental organizations involved in addressing cases of violence. Participants reported low condom use with intimate partners compared to paying clients. Top on the list of the problems associated with condom use was condom breakage, which was attributed to dryness, lack of lubricants and lengthy duration of sex. In addition, both male and female participants had power over decision making on condom use. Generally, as noted in transcripts, interactions between FSWs and clients switch between commercial sexual relationships and transactional liaisons. Conclusion The study provides insight into the structure and operational dynamics occurring at venues facilitating sexual networks. Simultaneously exposing the barriers and challenges to HIV prevention service delivery. A combination of strategies-behavioural, biomedical, structural interventions are required in addressing the needs of FSWs. Disclosure No significant relationships.

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