Andrews Carin Hillerdal, Faxelid Elisabeth, Sychaerun Vanphanom, Phrasisombath Ketkesone
Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
BMC Womens Health. 2015 Aug 19;15:63. doi: 10.1186/s12905-015-0215-0.
Female sex workers (FSWs) are a high-risk population for HIV. Correct and consistent use of condoms is the most effective measure for reducing transmission of HIV. Lao PDR is a low HIV-prevalence country, but FSWs have a relatively high HIV prevalence. To be able to make recommendations for condom promotion interventions in Lao PDR it is important to know more about the context specific situation. This study looked at reasons for and associated factors of consistent condom use among FSWs.
A cross-sectional survey among 258 FSWs in Kaysone Phomvihan district in Savannakhet province was performed.
Almost all FSWs had enough condoms (94%), condoms always available (100%) and could always afford condoms (92%). Consistent condom use was 97% with non-regular partners and 60% with regular partners. Almost all respondents (95%) had received information about condoms from the drop-in centre. Stated reasons for consistent condom use were prevention of HIV (94%), STIs (88%) and pregnancy (87%). Most reasons for inconsistent condom use were related to partners not wanting to use condoms because of reduced sexual pleasure. Some FSWs reported that they were physically abused and forced not to use condoms. Shorter time in sex work, higher education and FSW not having regular partners were significantly associated with consistent condom use.
Consistent condom use was very high with non-regular partners, but less frequent with regular partners. The main reason for inconsistent condom use was that the partner did not want to use a condom. Associated factors for consistent condom use were not having regular partners, higher education and shorter time in sex work. Condom promotion programs should include both FSWs and their partners and female condoms should be included in condom intervention efforts. Future studies should investigate the validity of self-reported sexual practices, partners' reasons for inconsistent condom use, risk of violence in sex work and why shorter time in sex work is associated with consistent condom use.
女性性工作者是感染艾滋病毒的高危人群。正确且持续使用避孕套是减少艾滋病毒传播的最有效措施。老挝是一个艾滋病毒感染率较低的国家，但女性性工作者的艾滋病毒感染率相对较高。为了能够为老挝的避孕套推广干预措施提出建议，了解更多具体情况很重要。本研究探讨了女性性工作者持续使用避孕套的原因及相关因素。
在沙湾拿吉省凯山·丰威汉县对258名女性性工作者进行了横断面调查。
几乎所有女性性工作者都有足够的避孕套（94%），随时都能拿到避孕套（100%），并且总能买得起避孕套（92%）。与非固定性伴侣持续使用避孕套的比例为97%，与固定性伴侣持续使用避孕套的比例为60%。几乎所有受访者（95%）都从救助中心获得了有关避孕套的信息。持续使用避孕套的既定原因是预防艾滋病毒（94%）、性传播感染（88%）和怀孕（87%）。不持续使用避孕套的大多数原因与性伴侣因性快感降低而不想使用避孕套有关。一些女性性工作者报告说她们遭受身体虐待并被迫不使用避孕套。从事性工作时间较短、受教育程度较高以及没有固定性伴侣的女性性工作者与持续使用避孕套显著相关。
与非固定性伴侣持续使用避孕套的比例非常高，但与固定性伴侣持续使用的频率较低。不持续使用避孕套的主要原因是性伴侣不想使用避孕套。持续使用避孕套的相关因素是没有固定性伴侣、受教育程度较高以及从事性工作时间较短。避孕套推广项目应将女性性工作者及其性伴侣都纳入其中，并且在避孕套干预措施中应纳入女用避孕套。未来的研究应调查自我报告的性行为的有效性、性伴侣不持续使用避孕套的原因、性工作中的暴力风险以及为何从事性工作时间较短与持续使用避孕套有关。
