Abstract
BackgroundFemale commercial sex workers (FSWs) are at high risk of human immunodeficiency virus (HIV) transmission in China. This study was designed to examine the predictors of condom use with clients during vaginal intercourse among FSWs based on the Information-Motivation-Behavioral Skills (IMB) model and to describe the relationships between IMB model constructs.MethodsA cross-sectional study was conducted in Jinan of Shandong Province, from May to October, 2009. Participants (N = 432) were recruited using Respondent-Driven Sampling (RDS). A self-administered questionnaire was used to collect data. Structural equation modeling was used to assess the IMB model.ResultsA total of 427 (98.8%) participants completed their questionnaires. Condom use was significantly predicted by social referents support, experiences with and attitudes toward condoms, self-efficacy, and health behaviors and condom use skills. Significant indirect predictors of condom use mediated through behavioral skills included HIV knowledge, social referents support, and substance use.ConclusionsThese results suggest that the IMB model could be used to predict condom use among Chinese FSWs. Further research is warranted to develop preventive interventions on the basis of the IMB model to promote condom use among FSWs in China.
Highlights
Female commercial sex workers (FSWs) are at high risk of human immunodeficiency virus (HIV) transmission in China
The mean number of FSWs which the participants knew in Jinan was 12.5 (SD = 7.9)
More than 80% of the FSWs answered the item “HIV infection spreads when people share needles for drug use with someone” correctly. These results suggest that more attention is needed toward strengthening education about specific HIV knowledge where it is lacking
Summary
Female commercial sex workers (FSWs) are at high risk of human immunodeficiency virus (HIV) transmission in China. Since the 1980 s the number of female commercial sex workers (FSWs) has markedly increased in China [1]. Most FSWs in China are young, mobile, less educated, and some FSWs have reported substance abuse [1,5]. They often trade sex in entertainment establishments/service sectors (e.g. dance hall, night clubs, restaurants, barber shop, and sauna parlors), are less likely to use condoms, and have high rates of sexually transmitted infections (STIs) [1,5]
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