Background and objective: The prevalence of oral sex increased from 27.1% in 1992 to 81.1% in 1997, with a concomitant increase in pharyngeal gonorrhea, among female sex workers in Singapore. The extent of condom use for oral sex among them is unknown.
Goal: To determine the prevalence of and factors associated with consistent condom use during oral sex.
Study design: A cross-sectional study of 225 women randomly selected from the surveillance scheme register of female brothel-based sex workers with a history of oral sex documented in their medical records.
Results: Slightly more than half (56.9%) consistently used condoms for oral sex compared to 97% for vaginal sex. Condom use was significantly higher among middle than high class sex workers (adjusted rate ratio: 1.52, 95% CI: 1.01-2.29) and those with negotiation skills (adjusted rate ratio: 1.95, 95% CI: 1.32-2.07).
Conclusion: Sex workers should be taught skills to negotiate condom use for oral sex.
PIP: Oral sex, which was once considered an uncommon sexual behavior, has become a relatively common practice. Its prevalence increased from 27.1% in 1992 to 81.1% in 1997, with a concomitant increase in pharyngeal gonorrhea among female sex workers in Singapore. The extent of condom use for oral sex among them is unknown. This cross-sectional study determined the prevalence of, and factors associated with, consistent condom use for oral sex among 225 female brothel-based sex workers, with paying clients in Singapore. Results indicated that slightly more than half (56.9%) consistently used condoms for oral sex compared to 97% for vaginal sex. Condom use was significantly associated with class of sex workers and negotiation skills. Significantly higher rates of condom use were found among high-class sex workers (adjusted rate ratio: 1.52; 95% CI: 1.01-2.29) and those with negotiation skills (adjusted rate ratio: 1.95; 95% CI: 1.32-2.07). In light of these findings, it is suggested that future interventions provide training to sex workers, particularly high-class ones, on negotiation concerning oral sex.