Predictors of Sexual Risk Reduction Among Mexican Female Sex Workers Enrolled in a Behavioral Intervention Study

Abstract

Objective We recently showed efficacy of an intervention to increase condom use among female sex workers (FSWs) in Tijuana and Ciudad Juarez, situated on the Mexico–United States border. We determined whether increases in condom use were predicted by social cognitive theory and injection drug user status among women randomized to this intervention. Methods Four hundred nine HIV-negative FSWs aged ≥18 years having unprotected sex with clients within the prior 2 months received a brief individual counseling session integrating motivational interviewing and principles of behavior change (ie, HIV knowledge, self-efficacy for using condoms, and outcome expectancies). Results Increases in self-efficacy scores were associated with increases in percent condom use (P = 0.008), whereas outcome expectancies were not. Female sex workers who inject drugs (FSW-IDUs) increased condom use with clients but not to the same extent as other FSWs (P = 0.09). Change in HIV knowledge was positively associated with change in percent condom use among FSW-IDUs (P = 0.03) but not noninjection drug users. Conclusions Increases in self-efficacy significantly predicted increased condom use among FSWs, consistent with social cognitive theory. Increased HIV knowledge was also important among FSW-IDUs, but their changes in condom use were modest. Enhanced interventions for FSW-IDUs are needed, taking into account realities of substance use during sexual transactions that can compromise safer sex negotiation.

Rethinking risk: Gender and injection drug-related HIV risk among female sex workers and their non-commercial partners along the Mexico–U.S. border

“…Female sex workers who inject drugs have higher HIV/STI prevalence than other sex workers (Strathdee et al, 2011), longer durations working in sex work, and more frequent drug use before sex (Strathdee et al, 2008). A behavioral intervention for sex workers did not increase injectors’ condom use with clients to the same extent as it did with non-injecting women (Patterson et al, 2008), reinforcing findings that addiction compromises condom negotiation (Strathdee et al, 2009). …”

Applying the Information-Motivation-Behavioral Skills Model in Medication Adherence Among Thai Youth Living with HIV: A Qualitative Study

“…MI, initially developed in the Western sociocultural settings, has been successfully used for various health behaviors in African, Central American, and Asian populations. [24][25][26][27][28] For those reasons MI was utilized in the current study.…”

The Relationship Between Alcohol Consumption and Human Immunodeficiency Virus Infection and Risk Behaviour: A Systematic Literature Review of High-Risk Groups, with a Focus on South Africa

“…Alcohol use prior to sex leads to inconsistent condom use for both male migrant workers as well as for FSWs. HIV/AIDS education and an increase in a sex worker's ability to use a condom effectively have been linked with decreased alcohol consumption and more frequent condom use, particularly among those FSWs who are also IDUs Strathdee et al, 2009;Morisky et al, 2010). A direct correlation between decreasing daily alcohol consumption and increasing consistent condom use was found in a sample of 911 FSWs (Morisky et al, 2010).…”