Baidoobonso Shamara, Bauer Greta R, Speechley Kathy Nixon, Lawson Erica
Epidemiology and Biostatistics, The University of Western Ontario, London, Canada.
Women's Studies and Feminist Research, The University of Western Ontario, London, Canada.
J Immigr Minor Health. 2016 Feb;18(1):67-85. doi: 10.1007/s10903-014-9984-z.
African, Caribbean, and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about condom use in this population. This exploratory community-based research project addresses this gap in knowledge. 125 sexually active ACB people completed a questionnaire covering condom use and social determinants of health. The data were analyzed using ordinal logistic regression and mediation analyses. 20.5 % of sexually active ACB adults used condoms consistently. Male gender, wealth, unstable immigration classes, and unsecure employment statuses were independently associated with more frequent condom use. Proximate determinants mediating these relationships included: not having a cohabiting regular partner, not disliking condoms, and having a history of unwanted sex. The proximate determinants mediated 85.7-97.6 % of the effects of the social determinants. These results link social context and proximate factors with condom use. They can be used to design evidence-informed interventions for ACB people.
非洲、加勒比及其他黑人（ACB）群体是加拿大艾滋病预防的重点人群，但对于该人群的避孕套使用情况却知之甚少。这个基于社区的探索性研究项目填补了这一知识空白。125名性活跃的ACB人群完成了一份涵盖避孕套使用及健康社会决定因素的调查问卷。数据采用有序逻辑回归和中介分析进行分析。20.5%的性活跃ACB成年人始终坚持使用避孕套。男性、财富、不稳定的移民类别以及无保障的就业状况与更频繁使用避孕套独立相关。介导这些关系的直接决定因素包括：没有同居的固定伴侣、不讨厌避孕套以及有过非自愿性行为史。直接决定因素介导了社会决定因素85.7%至97.6%的影响。这些结果将社会背景和直接因素与避孕套使用联系起来。它们可用于为ACB人群设计基于证据的干预措施。
