Strathdee Steffanie A, Mausbach Brent, Lozada Remedios, Staines-Orozco Hugo, Semple Shirley J, Abramovitz Daniela, Fraga-Vallejo Miguel, Torre Adela de la, Amaro Hortensia, Martínez-Mendizábal Gustavo, Magis-Rodríguez Carlos, Patterson Thomas L
Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0680, USA.
J Acquir Immune Defic Syndr. 2009 May 1;51 Suppl 1(Suppl 1):S42-6. doi: 10.1097/QAI.0b013e3181a265b2.
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.
Four hundred nine HIV-negative FSWs aged >or=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).
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.
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.
我们最近在位于美墨边境的蒂华纳和华雷斯展示了一项干预措施在增加女性性工作者（FSW）使用避孕套方面的效果。我们确定了随机接受该干预措施的女性中，避孕套使用的增加是否可由社会认知理论和注射吸毒者状况预测。
409名年龄≥18岁、在过去2个月内与嫖客有过无保护性行为的HIV阴性FSW接受了一次简短的个体咨询，咨询整合了动机性访谈和行为改变原则（即HIV知识、使用避孕套的自我效能感和结果期望）。
自我效能感得分的增加与避孕套使用百分比的增加相关（P = 0.008），而结果期望则不然。注射毒品的女性性工作者（FSW-IDU）与嫖客使用避孕套的情况有所增加，但增幅不及其他FSW（P = 0.09）。HIV知识的改变与FSW-IDU中避孕套使用百分比的改变呈正相关（P = 0.03），但与非注射吸毒者无关。
自我效能感的增加显著预测了FSW中避孕套使用的增加，这与社会认知理论一致。HIV知识的增加在FSW-IDU中也很重要，但她们在避孕套使用方面的改变幅度较小。需要针对FSW-IDU加强干预措施，考虑到性交易期间物质使用的现实情况，这可能会影响安全性行为的协商。
