Condom breakage during commercial sex in Chiang Mai, Thailand
Rugpao, S.; Pruithithada, N.; Yutabootr, Y.; Prasertwitayakij, W.; Tovanabutra, S.
Contraception 48(6): 537-547
1993
ISSN/ISBN: 0010-7824 PMID: 8131395 DOI: 10.1016/0010-7824(93)90116-oDocument Number: 332979
Brothel-based female prostitution has been the most important source of HIV spread in Thailand, especially in Chiang Mai. Proper and consistent use of condoms during sexual intercourse greatly minimizes the risk of HIV transmission between sex partners. Condoms do, however, occasionally rupture during use. The authors examined used condoms for breakage in thirty female brothels in Chiang Mai, Thailand, over the period August-October 1992, to assess the true level of breakage among users in such a context. 326 prostitutes, or 65% of prostitutes providing condoms, were also interviewed. The women were of mean age 20.6 years and had been working as prostitutes for a median duration of thirteen months. They reported having an average 4.4 clients during the preceding 24 hours, but an average 5.5 clients per day during the preceding three months. All refused to practice oral or anal sex during the preceding 24 hours. Of 5559 condoms, 298 were used two at a time and fifteen were used three at a time. Examination found a 5.9% rate of condom breakage per act of intercourse and a 5.7% rate of breakage per total condoms examined. Most breakage occurred in the distal region of the condom. The breakage rate per client as estimated by prostitutes during the preceding 24 hours corroborated with that assessed by examination. Breakage related to manufacturing defect and use was 0.8% and 5.0%, respectively, with a 3.4% probability of condom breakage when two were used at the same time. No difference was found between the breakage rates of condoms provided by the brothels and those brought by the client, nor was there any difference between manufacturing defect or use.