Gu Jing, Lau Joseph T F, Chen Xi, Liu Chuliang, Liu Jun, Chen Hongyao, Wang Renfan, Lei Zhangquan, Li Zhenglin
School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
AIDS Care. 2009 Aug;21(8):967-75. doi: 10.1080/09540120802657548.
Female injecting drug users who are sex workers (IDUFSWs) is a strategic "bridge population" for HIV transmission. Goals of the study were to investigate condom use behaviors during commercial sex among IDUFSWs using the Theory of Planned Behavior (TPB), and to investigate moderating effects that modify the strength of associations between the TPB-related variables and inconsistent condom use during commercial sex. A total of 281 non-institutionalized IDUFSWs were recruited using snowball sampling method. Anonymous face-to-face interviews were administered by trained doctors. The results showed that the prevalence of inconsistent condom use during commercial sex in the last six months was 64%. After adjusting for some significant background variables (e.g. main venue of sex work), all associations between the five TPB-related variables and the studied condom use variable were statistically significant (Odds Ratio (OR) = 0.43-0.68, p<0.001). In the hierarchical nested models, three background variables (age, venue of sex work, and ever used HIV-related interventions) entered in the first step (-2LL = 294.98, p<0.001) and the Social Norm Scale, the Perceived Behavioral Control Scale and the Behavioral Intention Scale were selected by the second step (OR = 0.67 - 0.72, p<0.01; -2LL = 160.99, p<0.001). Significant moderating effects between some TPB-related variables (Positive Condom use Attitude Scale and Behavioral Intention Scale) and duration of sex work and duration of drug use were also reported. The results highlighted the potential of using the TPB to better understand condom use behaviors in IDUFSWs in China. Theory-based research and intervention work should be developed in China in the future.
身为性工作者的女性注射吸毒者（IDUFSW）是艾滋病毒传播的一个关键“桥梁人群”。本研究的目的是运用计划行为理论（TPB）调查IDUFSW在商业性行为中使用避孕套的行为，并调查调节效应，这些效应会改变TPB相关变量与商业性行为中不一致使用避孕套之间关联的强度。采用滚雪球抽样法共招募了281名非机构化的IDUFSW。由训练有素的医生进行匿名面对面访谈。结果显示，在过去六个月中，商业性行为中不一致使用避孕套的发生率为64%。在调整了一些重要的背景变量（如性工作的主要场所）后，五个TPB相关变量与所研究的避孕套使用变量之间的所有关联均具有统计学意义（优势比（OR）=0.43 - 0.68，p<0.001）。在分层嵌套模型中，第一步纳入了三个背景变量（年龄、性工作场所和是否曾使用与艾滋病毒相关的干预措施）（-2LL = 294.98，p<0.001），第二步选择了社会规范量表、感知行为控制量表和行为意图量表（OR = 0.67 - 0.72，p<0.01；-2LL = 160.99，p<0.001）。还报告了一些TPB相关变量（积极使用避孕套态度量表和行为意图量表）与性工作时长和吸毒时长之间的显著调节效应。结果突出了运用TPB更好地理解中国IDUFSW中避孕套使用行为的潜力。未来中国应开展基于理论的研究和干预工作。
