Department of Epidemiology and Bio-statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
Sex Transm Dis. 2013 Mar;40(3):264-70. doi: 10.1097/OLQ.0b013e31827c58c9.
The female condom (FC) is an effective tool for dual protection, but it remains underused. Individual and contextual reasons need to be explored.
The aim of this study was to compare individual and contextual characteristics of FC multitime users, 1-time users, and nonusers among women in the sex industry of 4 study sites in China.
A standardized 1-year FC intervention along with male condoms was implemented through outreach to sex establishments. Three serial cross-sectional surveys were conducted at baseline and after each of two 6-month intervention phases.
A total of 445, 437, and 290 eligible women were interviewed at 3 cross-sectional surveys, respectively. At the first and second postintervention surveys, 83.3% and 81.7% of women reported knowing about FC, and 28.8% and 36.6% had used FC at least once. Women who used FC multiple times reported less unprotected sex than nonusers in the last 30 days (3.0% vs. 17.2% at first and 3.2% vs. 16.8% at second postintervention survey, P < 0.01). Polytomous logistic regression showed that both 1-time and multitime users were more likely to come from one particular site (approximately 3 times more than the reference site). Higher intervention scores (adjusted odds ratio, 1.8-4.0) and working in boarding houses (adjusted odds ratio, 3.4) were associated with FC use.
Adding FC into male-condom-only intervention may reduce unprotected sex among women in sex establishments in rural and small urban areas of China. Adoption of FC may be related not only to intervention exposure but also to contextual factors associated with study site and type of sex establishments.
女用避孕套（FC）是一种有效的双重保护工具，但使用率仍然较低。需要探讨个人和环境因素。
本研究旨在比较中国 4 个研究地点性工作者中 FC 多次使用者、单次使用者和非使用者的个人和环境特征。
通过对性场所的外展，实施了为期 1 年的标准化 FC 干预措施，同时使用男用避孕套。在基线和两次 6 个月干预阶段后分别进行了 3 次横断面调查。
在 3 次横断面调查中，分别有 445、437 和 290 名符合条件的女性接受了访谈。在第一次和第二次干预后调查中，83.3%和 81.7%的女性报告了解 FC，28.8%和 36.6%的女性至少使用过一次 FC。与非使用者相比，多次使用 FC 的女性在过去 30 天内的无保护性行为较少（第一次和第二次干预后调查分别为 3.0%和 17.2%，3.2%和 16.8%，P < 0.01）。多项逻辑回归显示，单次使用者和多次使用者更有可能来自特定的一个地点（相对于参考地点，大约是其 3 倍）。较高的干预评分（调整后的优势比，1.8-4.0）和在寄宿处工作（调整后的优势比，3.4）与 FC 使用相关。
在仅使用男用避孕套的干预措施中加入 FC 可能会减少中国农村和小型城市地区性场所中女性的无保护性行为。FC 的采用不仅与干预接触有关，还与与研究地点和性场所类型相关的环境因素有关。
