Lau Joseph T F, Gu Jing, Tsui Hi Yi, Chen Hongyao, Holroyd Eleanor, Wang Renfan, Hu Xianyou
School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
Sex Health. 2012 Sep;9(4):368-76. doi: 10.1071/SH11108.
We compared the prevalence of inconsistent condom use during commercial sex between female sex workers (FSWs) who did or did not inject drugs (FSW-IDUs and FSW-NIDUs) and investigated factors associated with this inconsistent use within these two groups.
Some 158 FSW-NIDUs recruited from sex work venues and 218 FSW-IDUs recruited via the snowball sampling method were interviewed anonymously.
Only 16.5% of the FSW-IDUs and 51.3% of the FSW-NIDUs had used condoms consistently during commercial sex in the last month (odds ratio (OR)=0.19). Factors significantly associated with inconsistent condom use in both groups included: behavioural intention for condom use (adjusted odds ratio (AOR)=0.05 and 0.13), condom unavailability (AOR=4.77 and 5.33), a perceived need to engage in unprotected sex if the client paid more (AOR=8.74 and 10.84) or insisted on demanding unprotected sex (AOR=19.78 and 7.59), and submissive gender power (AOR=11.65 and 2.58). One factor, perceived susceptibility (AOR=2.64), was significant only among FSW-NIDUs, whereas perceived efficacy of condom use in preventing HIV transmission (AOR=0.08), perceptions that peer FSWs would not use condoms with clients (AOR=2.23), self-hatred (AOR=2.25) and lack of social support (AOR=2.93) were significant only among FSW-IDUs. Injecting with used syringes was also associated with inconsistent condom use among FSW-IDUs (AOR=4.64).
FSW-IDUs were more likely than FSW-NIDUs to possess the cognitive and psychosocial conditions associated with unprotected commercial sex. Interventions need to take these differences into account.
我们比较了注射毒品的女性性工作者（FSW-IDU）和不注射毒品的女性性工作者（FSW-NIDU）在商业性行为中避孕套使用不一致的发生率，并调查了这两组中与这种不一致使用相关的因素。
对从性工作场所招募的约158名FSW-NIDU和通过滚雪球抽样法招募的218名FSW-IDU进行匿名访谈。
在上个月的商业性行为中，只有16.5%的FSW-IDU和51.3%的FSW-NIDU始终使用避孕套（优势比（OR）=0.19）。两组中与避孕套使用不一致显著相关的因素包括：使用避孕套的行为意图（调整后的优势比（AOR）=0.05和0.13）、无法获得避孕套（AOR=4.77和5.33）、认为如果客户支付更多或坚持要求无保护性行为就有必要进行无保护性行为（AOR=8.74和10.84），以及顺从的性别权力（AOR=11.65和2.58）。一个因素，即感知易感性（AOR=2.64），仅在FSW-NIDU中显著，而认为避孕套在预防艾滋病毒传播方面的功效（AOR=0.08）、认为同行FSW不会与客户使用避孕套（AOR=2.23）、自我厌恶（AOR=2.25）和缺乏社会支持（AOR=2.93）仅在FSW-IDU中显著。使用用过的注射器注射也与FSW-IDU中避孕套使用不一致有关（AOR=4.64）。
FSW-IDU比FSW-NIDU更有可能具备与无保护商业性行为相关的认知和心理社会状况。干预措施需要考虑到这些差异。
