Social, psychological, and environmental-structural factors determine consistent condom use among rural-to-urban migrant female sex workers in Shanghai China

Abstract

BackgroundTo determine potential social, psychological, and environmental-structural factors that may result in motivating female sex workers (FSWs), who are rural-to-urban migrants, and their paying partners in Shanghai, China to promote consistent condom use (CCU).MethodsA cross-sectional study was conducted in five districts of Shanghai, including three suburbs and two downtown locales. We adopted a cluster randomized sampling method to obtain 20 geographic sites, which consisted of 1 or more communities/villages proximal to a location where FSWs were accessible. Five hundred four FSWs from 132 Xitou Fang (shampoo wash rooms), massage parlors, and hair salons who explicitly provided sexual services were enrolled in the study. Each participant completed a questionnaire survey and interview aimed to collect information on the perceptions and behaviors of individuals associated with a risk for human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS),self-efficacy at negotiating safe sex,and the physical, social, and policy environment of the establishments where they worked.ResultsThe percentage of FSWs who reported consistent condom use with their paying partners was 63.3%. Controlling for socio-demographic characteristics in multivariate analyses, environmental-structural support (OR, 3.96; CI, 2.52–6.22) for condom use was the most significant positive predictor of CCU among FSWs and their regular paying partners. A high perception of susceptibility and risk of HIV/AIDS (OR, 1.96; CI, 1.25–3.01), a high perception of benefits on condom use to protect themselves (OR, 2.06; CI, 1.32–3.22), and high safe sex self-efficacy (OR, 2.52; CI, 1.64–3.85) also play important roles on CCU based on multivariate analyses.ConclusionsEnvironmental-structural factor support for condom use, in addition to social, psychological, and individual cognitive factors are significant predictors of CCU among FSWs, which should be assessed and addressed in research and interventions related to HIV/AIDS prevention among FSWs in China.

Global epidemiology of HIV among female sex workers: influence of structural determinants

“…Few investigators have examined the nuanced and intersecting influence of policy, social, and physical features of the work environment in the mitigation or conferment of HIV risk among FSWs. The authors of these studies examined how supportive venue-based policies 30, 32, 76, 77, 78, 79, 80, 81 or managerial practices (eg, client sign-in, safety mechanisms, or removal of violent clients) 48, 69, 76, 77, 80, 81, 82, 83, 84, 85 and physical features (eg, types or layout of venues) of sex work establishments are associated with increased condom use, often through synergistic effects with other social features of increased peer or sex worker support 32, 52, 53, 69, 72, 76, 79, 81, 83, 85, 86, 87, 88, 89, 90. Work environments for FSWs are shaped by economic features (eg, economic pressures, client financial incentives for non-condom use, refusal of payment, and bribes or fines by state agents [eg, police] to avoid arrest) resulting from macrostructural forces of poverty, laws, and access to resources and are associated with non-condom use27, 28, 29, 30, 40, 41, 48, 64, 70, 83, 84, 87, 91, 92, 93 and HIV infection among FSWs.…”

“…Where FSWs report adequate access to condoms, sexual health care (eg, STI testing and contraceptives) and HIV care (eg, HIV testing, ART, and sex worker-tailored clinics), increases are noted in condom use and reduced condom breakage, 39, 40, 32, 44, 47, 67, 79, 95, 96, 97, 98, 99 and lower HIV prevalence. 100, 101 Condom coverage must include condom access (eg, free or subsidised condoms at the workplace, the ability to carry condoms while working, and contact with peer condom distribution), availability and affordability, linked to reduced HIV acquisition and transmission among FSWs 25, 30, 39, 40, 44, 47, 68, 70, 79, 82, 84, 87, 93, 95, 97, 98, 99, 102, 103, 104, 105, 106, 107…”

The Knowledge and Behaviour of Female Sex Workers towardsthe Risk of HIV/AIDS: A Review.

“…Individual perception of susceptibility to HIV/AIDS and benefits of condom use are important factors in determining condom use and cognitive information through health education is an effective promotion (Ye et al, 2012). Most of sex workers knew and were aware of HIV/AIDS and the common source of information about HIV/AIDS was from television (Giri et al, 2012) and doctors (Lau, Tsui, Siah, & Zhang, 2010).However, studies found that knowledge is not always directly associated with behavior change (Pattanaphesaj & Teerawattananon, 2010).…”

“…Approximately 13% of respondents in a study in China reported that it was difficult to get condoms when needed particularly for younger, 59,3% said that pharmacy shops were the most convenient place to buy a condom and 7,9% stated that they did not know how to use a condom (Lau et al, 2010). Condom availability may not be a major factor affecting condom use, as a research in China with 504 respondents investigated that social, psychological, and environmentalstructural factors are very important in determining consistency condom use among female sex workers and their clients (Ye et al, 2012). Therefore, supports from the establishment owner (employers), accessibility of condoms, supports from community health care providers are very necessary ( …”

Using Peer Educators to Promote HIV Awareness Among Male Migrants in Mexico

“…For example, self-efficacy has been found to be associated with increased AIDS knowledge and condom use among migrant workers in Thailand (Ford, Chamratrithirong, Apipornchaisakul, Panichapak, & Pinyosinwat, 2013). A high level of perceived susceptibility and risk of HIV infection was found to be associated with consistent condom use among migrant female sex workers in Shanghai, China (Ye et al, 2012). Similarly, among Ghanaian immigrants in the United States, perceived behavioral control has been found to predict intentions to use condoms, and intentions to use condoms, in turn, predicted condom use (Asare & Sharma, 2009-2010 In response to the growth in the number of migrants, a number of services have been developed in Mexicali to respond to their needs.…”