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Article << Previous     |     Next >>   Contents Vol 9(4)

Prevalence and associated factors of condom use during commercial sex by female sex workers who were or were not injecting drug users in China

Joseph T. F. Lau A B F, Jing Gu B C, Hi Yi Tsui A, Hongyao Chen D, Eleanor Holroyd E, Renfan Wang D and Xianyou Hu D

A Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong.
B Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou 510000, China.
C Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510000, China.
D Dazhou Center for Disease Control and Prevention, Dazhou 635000, Sichuan, China.
E Division of Nursing and Midwifery, School of Health Sciences, RMIT University, Melbourne, Vic. 3001, Australia.
F Corresponding author. Email: jlau@cuhk.edu.hk

Sexual Health 9(4) 368-376 http://dx.doi.org/10.1071/SH11108
Submitted: 4 August 2011  Accepted: 30 January 2012   Published: 11 May 2012
 
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Abstract

Objectives: We compared the prevalence of inconsistent condom use during commercial sex between female sex workers (FSWs) who did or did not inject drugs (FSW-IDUs and FSW-NIDUs) and investigated factors associated with this inconsistent use within these two groups. Methods: Some 158 FSW-NIDUs recruited from sex work venues and 218 FSW-IDUs recruited via the snowball sampling method were interviewed anonymously. Results: Only 16.5% of the FSW-IDUs and 51.3% of the FSW-NIDUs had used condoms consistently during commercial sex in the last month (odds ratio (OR) = 0.19). Factors significantly associated with inconsistent condom use in both groups included: behavioural intention for condom use (adjusted odds ratio (AOR) = 0.05 and 0.13), condom unavailability (AOR = 4.77 and 5.33), a perceived need to engage in unprotected sex if the client paid more (AOR = 8.74 and 10.84) or insisted on demanding unprotected sex (AOR = 19.78 and 7.59), and submissive gender power (AOR = 11.65 and 2.58). One factor, perceived susceptibility (AOR = 2.64), was significant only among FSW-NIDUs, whereas perceived efficacy of condom use in preventing HIV transmission (AOR = 0.08), perceptions that peer FSWs would not use condoms with clients (AOR = 2.23), self-hatred (AOR = 2.25) and lack of social support (AOR = 2.93) were significant only among FSW-IDUs. Injecting with used syringes was also associated with inconsistent condom use among FSW-IDUs (AOR = 4.64). Conclusions: FSW-IDUs were more likely than FSW-NIDUs to possess the cognitive and psychosocial conditions associated with unprotected commercial sex. Interventions need to take these differences into account.

Additional keywords: health behavioural theories, HIV, psychological factors, sexually transmissible infections.


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