SWs face a disproportionate burden of STIs, violence, and other human rights violations. While recent HIV prevention research has largely focused on the HIV cascade, condoms remain a cornerstone of HIV prevention, requiring further research attention. Given serious concerns regarding barriers to condom use, including policing, violence, and ‘end-demand’ sex work criminalization, we evaluated structural correlates of difficulty accessing condoms among SWs.
There were in total of 884 participants, out of the 19.1% reported difficulty accessing condoms during the study. In multivariable GEE analysis, exposure to end-demand legislation was not associated with improved condom access; identifying as a sexual/gender minority, servicing outdoors, physical/sexual workplace violence, community violence, and police harassment were associated with enhanced difficulty accessing condoms.
The study concluded that one-fifth of SWs faced challenges accessing condoms, suggesting the need to scale-up SW-tailored HIV/STI prevention. Despite the purported goal of ‘protecting communities’, end-demand criminalization did not mitigate barriers to condom access, while sexual/gender minorities and those facing workplace violence, harassment, or those who worked outdoors experienced the poorest condom accessibility. Decriminalization of sex work is needed to support SWs’ labor rights, including access to HIV/STI prevention supplies.