Anal and Dry Sex in Commercial Sex Work, and Relation to Risk for Sexually Transmitted Infections and HIV in Meru, Kenya

The aim of the current study was to examine the practice of anal and dry sex within a cohort of female sex workers (FSWs) in Meru, Kenya. A survey was conducted among FSWs: 147 participants were randomly sampled from an existing cohort of self-identified FSWs. In collecting data, the researchers focused on the prevalence and perceived risk of these practices, demographic and behavioral correlates and association with STDs.

In the survey, 40.8 percent of FSWs reported ever practicing anal sex; 36.1 reported ever practicing dry sex. The majority of participants believed the two practices to be high-risk for contracting HIV in comparison to vaginal sex. However, about one-third of FSWs reported rarely or never using condoms during anal sex; about 20 percent reported rarely or never using condoms during dry sex. FSWs reported consistent condom use less frequently with both these practices than with penile-vaginal intercourse.

Anal intercourse was associated with experience of recent forced sex; dry sex was not. While anal sex was nearly always initiated by clients, FSWs themselves were more likely to initiate dry sex. FSWs charged higher fees for both practices than for vaginal intercourse, and both practices were associated with reported STD symptoms and diagnoses.

The researchers concluded that both practices were "common in this sample," and that while both were perceived to be high-risk practices, they "were not adequately protected with condom use. Education and other interventions regarding these high risk sexual behaviors need to be translated into safer practices, particularly consistent condom use, even in the face of financial vulnerability," they wrote.

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