Hesperian Health Guides

Hesperian Health Guides

How to Protect Yourself from STIs, Including HIV

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HealthWiki > Where Women Have No Doctor > Chapter 20: Sex Workers > How to Protect Yourself from STIs, Including HIV


In this chapter:

“If they don’t want to use a condom, I ask them if they ever listen to the news, if they have ever heard of AIDS. I tell them I’m not willing to take the chance.” —Jolanda

If you exchange sex for money, housing or other kinds of support, it is important to protect yourself from STIs and HIV. For more information, see the section on “Safer Sex”, and the chapters on “Sexually Transmitted Infections and Other Infections of the Genitals”, and “Family Planning”.

Here are some other ideas: a woman sitting on a bed holding a condom while a man undresses

  • Use latex condoms every time you have sex. Make sure you always have condoms when you work.
  • Hand sex (manual masturbation), oral sex, or sex stories (fantasy), are safer than sex in your vagina or anus if you cannot get a client to use a condom.
  • If you are unable to use a male or female condom, using a diaphragm will give some protection, though less than a condom. You can put your diaphragm in before you begin work, in case a man refuses to use a condom.
diaphragm

Protecting yourself and others from STIs means having safer sex with your clients, and also with your husband or boyfriend.

To prevent pregnancy, a diaphragm is usually used with spermicide. But using spermicides too often can irritate the skin in your vagina, making it easier for germs to pass through the skin and infect you with an STI, especially HIV. Spermicides used every other day are less likely to cause irritation. This means that using a diaphragm with spermicide is not a good way for most sex workers to prevent pregnancy.

IMPORTANT! Do not use chemicals like bleach or detergent to wash out your vagina. They can cause serious injury!
  • Inspect your clients’ genitals for sores or discharge before you have sex. Refuse to have unprotected sex with any man who has signs of an STI. Remember you cannot tell by looking if a person has HIV infection.

Treatment for STIs when protection fails

It is always best to prevent STIs by practicing safer sex. But sometimes these methods fail. Condoms can break, or clients can refuse to use them.

STIs that are not treated quickly can lead to serious illness and even death.

Get early treatment

If you think you have been exposed to an STI, early treatment can prevent the infection from getting worse. STIs that are not treated quickly can lead to serious illness and even death.

If possible, have regular exams for STIs. If you are having signs of an STI— discharge or bleeding from your vagina, pain or sores on your genitals, or pain in your lower belly—see a health worker trained to treat STIs as soon as possible. Even if you have no signs of infection, go to a health center or clinic at least once a month for treatment if you have unsafe sex often. If you use condoms every time you have sex, you may need to visit a health center less often.

a woman walking to the door of a building
Health Center

Since you probably do not know what STIs you have been exposed to, you should be treated for as many as possible. Different antibiotics can treat different STIs, so you may need to take several medicines at once. Remember, no medicine can cure HIV. See the chapter on “Sexually Transmitted Infections and Other Infections of the Genitals” for information about how to treat STIs.

Testing for HIV

If you want to be tested for HIV, see 'The HIV Test'. Check with your local clinic to see if they have a National AIDS Control Program. They may have special programs for testing sex workers for HIV and for treating them if they have AIDS.

IMPORTANT! When you take antibiotics to treat STIs, be sure to take the recommended dose for the full amount of time. If you take too small an amount, or do not take it for the right number of days, your signs may go away, but the infection stays in your body and continues to cause damage. And the next time you try to treat the infection it will be harder to cure. Then you may need to use other, more expensive drugs. Many medicines that once worked for STIs are no longer effective because people used them incorrectly.


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