Table 2.
Facilitators and strategies of safer sex after antiretroviral rollout, interviews with female Kenyan sex workers 2006
| Level | Quotes | Respondent |
|---|---|---|
| STRUCTURAL DETERMINANTS | ||
| Gender Attitudes (distrust) | A man of that nature [who refuses to use a condom] you note that he has something he wants to infect you with so someone like that you leave him. | 36 year-old divorced HIV positive woman ART naïve |
| Nowadays men are very harsh [and] when you see a man refusing that thing [a condom] he is not well. | 29 year-old divorced HIV negative woman | |
| If you get someone who doesn’t want to use the condom you have to fear them. Why don’t they want to use the condom? Is that person OK, really? | 40 year-old divorced HIV positive woman on ART | |
| SEXUAL NETWORK DETERMINANTS | ||
| Multiple and Concurrent Partnerships | I haven’t told him [my HIV status] he has his wife so it’s like we are stealing what we do….. yes you just tell him I don’t know you and you don’t know me, I may be sick or you are sick and you have a family and I do too so let’s use the condom. | 46 year-old never married HIV positive woman not on ART |
| Some you will find when a man goes out of his marriage will carry a condom to use…[Women who “move out” engage multiple partnerships]..carries her own condoms so you will find these are people with something they are protecting so they don’t get infected so that they don’t infect also. | 34 year-old divorced HIV positive woman on ART | |
| INDIVIDUAL DETERMINANTS | ||
| Knowledge of Serostatus (HIV testing) | After I was told I don’t have the virus I got encouraged and said “No man will joke around with me.” I will protect myself. | 35 year-old divorced HIV negative woman |
| I tell someone if they have never gone for VCT they should go because it is very good whether you are affected or not. When you go there and find that you are negative you will change your behavior very fast and if you are positive you will also change your behavior. | 37 year-old never married HIV positive woman ART naïve | |
| Partnership Type (focus on short-term relationships) | [I do not have a friend living with me]…nowadays if you have a friend and you live with [him] for a month he will not agree to use [a condom] anymore he will refuse so I don’t like. I am cunning it’s better if I stay without. | 35 year-old never married HIV positive woman on ARV |
| Concern about Co-infections (including HIV superinfection) | [I use a condom] because I know my status and we were told here [study clinic] that now we are on drugs, when you go with someone you don’t know him and maybe he has his, and you have yours if you don’t use a condom he will give you another that you didn’t have, so you will add more onto what you already have. | 44 year-old divorced HIV positive woman on ART |
| Ah but when you don’t use that [condom], that is when they will add onto you, you may have it [HIV] and they also have it [HIV] and yours is little his is much so you will be added. | 35 year-old divorced HIV positive woman on ART | |
| Even for me when I was tested positive I stayed for almost 2 years without having sex with anyone because of fearing and also I was imagining like everyone I had would add onto me the disease and then I would die faster. | 32 year-old divorced HIV positive woman ART naïve | |