Condom use among female commercial sex workers and male clients in Hong Kong

Int J STD AIDS. 1994 Jul-Aug;5(4):287-9. doi: 10.1177/095646249400500412.


The use of condoms is an aid to protection against human immunodeficiency virus (HIV) infection and other sexually transmitted diseases (STDs). In a one-and-a-half month period in mid-1993, 190 commercial female sex workers and 633 male clients of 8 Social Hygiene Clinics in Hong Kong were interviewed on their practice in condom usage. For both sex workers and clients, 18.5% and 22.8% never and 55.3% and 50.3% seldom used condoms during sexual contacts with paying partners and non-paying partners respectively. The majority (86%) of male clients claimed that they would use a condom if they knew it could reduce risk of contracting HIV and other STD. Condom promotion activities are necessary, particularly for those at higher risk of infection because of their sexual behaviour.

PIP: To obtain baseline data and reference material for the design of human immunodeficiency virus (HIV) prevention programs, condom use among Hong Kong's commercial sex workers was investigated for the first time. Interviews were conducted with 190 female sex workers and 633 male clients recruited from Department of Health Social Hygiene Clinics between April and mid-May 1993. Frequency of condom use per 10 sexual contacts was rated as never, seldom (1-3), sometimes (4-6), often (7-9), or always. With paying male clients, these rates were 11,1%, 7.4%, 11.1%, 32.1%, and 37.9%, respectively. With non-paying sexual partners, however, these rates were 51.6%, 3.7%, 7.9%, and 18.4%. There was a significant difference in condom use rates with clients between sex workers over 30 years of age (64%) and their younger counterparts (87%). Among the male clients of prostitutes, condom use was as follows: never, 11.1%; seldom, 11.7%; sometimes, 9.6%; often, 17.5%; and always, 45.2%. The reasons most frequently cited by these men for non-use of condoms were: sexual partner considered reliable (46%), reduced sexual pleasure (26%), and lack of availability (22%). On the other hand, 86% indicated they would use a condom if convinced it would reduce the risk of HIV and other sexually transmitted diseases and 43% would use condoms if requested or provided by their partner. These findings suggest that the transmission of HIV by female sex workers could be substantially curtailed through the provision of free condoms to prostitutes, counseling to enable these women to take the initiative in insisting on condom use, and educational campaigns that emphasize the effectiveness of condoms in HIV prevention.

MeSH terms

  • Adult
  • Condoms / statistics & numerical data*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Promotion
  • Hong Kong / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Sex Work* / psychology
  • Sexual Partners* / psychology
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / prevention & control
  • Sexually Transmitted Diseases / transmission