Female sex workers in Lyantonde town say they need access to female condoms to protect themselves from HIV. Although female condoms have been shunned since being introduced in Uganda in the 1990s, sex workers say they need them because their clients refuse to use male condoms.
Lyantonde is a hot spot for sex work because it is a stopover for truck drivers who operate long-distance routes. The truck drivers come from within Uganda and neighbouring countries including Democratic Republic of Congo, Rwanda, Burundi, Tanzania and Kenya.
Since sex work is illegal in Uganda, the number of female sex workers in the area is unknown. However investigations carried out by Lyantonde Town Council reveal that girls as young as 13 are engaging in sex work to earn a living.
Sex workers speak out
When they were interviewed, some of the sex workers said that during the day they engage in businesses like retail shops, tailoring and house-keeping, while at night they sell sex. The women also said they can earn anything from 5,000 shillings to 100,000 shillings ($US 38) per night, depending on the client and whether or not they use a condom.
"Getting a client who pays 100,000 shillings is extremely rare and it is mostly Somalis who pay such huge amounts of money - insisting on no condom use," said Annet*, aged 35. "Due to poverty, I had been accepting such money but, with the increasing AIDS risk, I no longer accept it."
Eighteen year old Rhoda* said that one truck driver can visit around three sex workers in a night without using a condom. "Since we share our HIV status amongst ourselves, I no longer want to risk my life, so now I protect myself," she said.
Sarah,* aged 25, said she and her colleagues had been wondering why condoms tear during sex, since their clients put them on properly. After thorough investigations, they discovered these men put Vaseline on their penises before putting on the condoms, knowing well that during the act they would tear, so they could have unprotected sex.
Higher fees without condoms
However some of the truck drivers who visit female sex workers accused them of deliberately removing the condoms during sex, so they can be paid a higher fee.
Abdallah,* a Somali national who speaks with pride about visiting female sex workers, said he would never use a condom. "Where is the enjoyment if I use a condom?" he asks. "I have my money so I can pay for any charges. I am also assured of antiretroviral treatment if I get the virus."
Musisi,* who works with a local manufacturing company, said that it is the sex workers who determine whether condoms should be used or not. "If the sex worker uses a female condom I will pay 5,000 shillings. Without a condom, I will pay 10,000 shillings," he explained.
Myths about female condoms
According to a 2012 behavioural study, carried out by the Uganda health marketing group and the United Nations Populations Fund, female condoms in Uganda are not as popular as male condoms. There is a misconception that the female condom does not fit around the opening of the vagina, so while in action, the penis pushes it further inside.
The study showed that although 80 per cent of respondents knew about female condoms, only three per cent used them, due to such misconceptions.
Another survey, carried out by the International Organization for Migration in 2012 among female sex workers and truckers at hot spots along transport corridors in Uganda, showed knowledge of condom use as a means of preventing HIV was high among female sex workers (97 per cent) but only around 50 per cent actually used them.
Lack of demand
Lyantonde district health officer Dr Okoth Obbo said that he had not yet received any requests from sex workers for female condoms.
"Although the district was receiving female condoms before, we stopped requesting them because there was no demand. However, if we get a formal request from the sex workers, we shall forward it to National Medical Stores," he said.
The spokesperson for National Medical Stores, Dan Kimosho, said that although they stock female condoms on an annual basis, demand has been low. "If it becomes a concern for female sex workers, we can provide as many as they want because they are not out of reach," he said.
Dr Oboth also said training female sex workers on how to use female condoms would be very easy, since some of them have already received training, so they can easily teach their colleagues. The sex workers themselves agree with this point.
Teo,* aged 38, said: "Since I have spent over 15 years in this business, I have attended numerous training sessions on how to use female condoms. So if they are available, I am very willing to teach my colleagues how to use them."