Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
PLoS One. 2012;7(11):e49542. doi: 10.1371/journal.pone.0049542. Epub 2012 Nov 20.
HIV infection related to commercial sexual contact is a serious public health issue in China. The objectives of the present study are to explore the predictors of condom use among female sex workers (FSWs) in China and examine the relationship between Health Belief Model (HBM) constructs.
METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was conducted in two cities (Wuhan and Suizhou) in Hubei Province, China, between July 2009 and June 2010. A total of 427 FSWs were recruited through mediators from the 'low-tier' entertainment establishments. Data were obtained by self-administered questionnaires. Structural equation models were constructed to examine the association. We collected 363 valid questionnaires. Within the context of HBM, perceived severity of HIV mediated through perceived benefits of condom use had a weak effect on condom use (r=0.07). Perceived benefits and perceived barriers were proximate determinants of condom use (r=0.23 and r=-0.62, respectively). Self-efficacy had a direct effect on perceived severity, perceived benefits, and perceived barriers, which was indirectly associated with condom use behaviors (r=0.36).
CONCLUSIONS/SIGNIFICANCE: The HBM provides a useful framework for investigating predictors of condom use behaviors among FSWs. Future HIV prevention interventions should focus on increasing perceived benefits of condom use, reducing barriers to condoms use, and improving self-efficacy among FSWs.
在中国，与商业性性接触相关的 HIV 感染是一个严重的公共卫生问题。本研究旨在探索中国女性性工作者（FSW）使用安全套的预测因素，并检验健康信念模型（HBM）各构成要素之间的关系。
方法/主要发现：本研究于 2009 年 7 月至 2010 年 6 月在湖北省的两个城市（武汉和随州）开展了一项横断面研究。通过“低层次”娱乐场所的中介，共招募了 427 名 FSW。通过自填式问卷收集数据。构建结构方程模型以检验相关性。我们共收集了 363 份有效问卷。在 HBM 的背景下，通过使用安全套的感知益处来体现的 HIV 感知严重性对安全套使用有微弱影响（r=0.07）。感知益处和感知障碍是安全套使用的直接决定因素（r=0.23 和 r=-0.62）。自我效能感对感知严重性、感知益处和感知障碍有直接影响，与安全套使用行为呈间接关联（r=0.36）。
结论/意义：HBM 为调查 FSW 安全套使用行为的预测因素提供了一个有用的框架。未来的 HIV 预防干预措施应侧重于提高使用安全套的感知益处，减少使用安全套的障碍，并提高 FSW 的自我效能感。
