Wong M L, Lubek I, Dy B C, Pen S, Kros S, Chhit M
Department of Community, Occupational and Family Medicine (MD 3), Faculty of Medicine, National University of Singapore, Singapore.
Sex Transm Infect. 2003 Apr;79(2):163-5. doi: 10.1136/sti.79.2.163.
To determine the social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia.
Using a structured behavioural questionnaire, interviews were conducted with 140 direct sex workers attending a health centre in Siem Reap for HIV screening.
Consistent condom use with their clients was reported by 78% of sex workers compared to only 20% with their non-paying partners. Consistent condom use with clients was significantly higher among higher income than lower income sex workers (adjusted prevalence ratio: 1.91, 95% CI: 1.15 to 3.18) and those with good rather than poor negotiation skills (adjusted prevalence ratio: 1.51, 95% CI: 1.01 to 2.26), after adjustment for age, educational level, marital status, number of sexual encounters per week, and knowledge of AIDS/HIV and sexually transmitted infections. The most frequently reported reason for not using condoms with clients was not being able to persuade them (66.7%), while for non-paying partners, the reason was that they loved them (60.0%).
To complement the government's current programme of client education, 100% condom policy and brothel administrative measures, additional strategies to increase condom use among clients and non-paying partners should be directed at (i) the social policy and community levels to address sex workers' economic and cultural barriers to condom use, and (ii) personal level empowerment through developing sex workers' condom negotiation skills.
确定柬埔寨暹粒直接从事性交易工作者中与使用避孕套相关的社会和行为因素。
采用结构化行为问卷，对140名前往暹粒一家健康中心进行艾滋病毒筛查的直接从事性交易工作者进行访谈。
78%的性工作者报告称与嫖客始终坚持使用避孕套，而与非付费性伴侣始终坚持使用避孕套的比例仅为20%。在对年龄、教育水平、婚姻状况、每周性接触次数以及艾滋病/艾滋病毒和性传播感染知识进行调整后，高收入性工作者与嫖客始终坚持使用避孕套的比例显著高于低收入性工作者（调整患病率比：1.91，95%置信区间：1.15至3.18），且谈判技巧良好的性工作者高于谈判技巧差的性工作者（调整患病率比：1.51，95%置信区间：1.01至2.26）。报告中最常见的不与嫖客使用避孕套的原因是无法说服他们（66.7%），而不与非付费性伴侣使用避孕套的原因是她们爱对方（60.0%）。
为补充政府当前的嫖客教育计划、100%避孕套政策和妓院管理措施，应针对以下方面采取额外策略以提高嫖客和非付费性伴侣使用避孕套的比例：（i）社会政策和社区层面，以解决性工作者在使用避孕套方面的经济和文化障碍；（ii）个人层面，通过培养性工作者的避孕套谈判技巧来增强其能力。
