Liu Hongjie
Department of Epidemiology and Biostatistics, University of Maryland School of Public Health , College Park, Maryland.
AIDS Patient Care STDS. 2016 Apr;30(4):155-65. doi: 10.1089/apc.2015.0349.
The epidemics of sexually transmitted infections (STIs) have spread among older adults in the world, including China. This study addresses the deficiency of studies about the multiple contextual influences on condom use among mid-age female sex workers (FSWs) over 35 years old. A combination of an egocentric network design and multilevel modeling was used to investigate factors of condom use over mid-age FSWs (egos) particular relationships with sexual partners (alters). Of the 1245 mid-age FSWs interviewed, 73% (907) reported having at least one sexual partner who would provide social support to egos. This generated a total of 1300 ego-alter sex ties in egos' support networks. Condoms were consistently used among one-third of sex ties. At the ego level, condoms were more likely to be used consistently if egos received a middle school education or above, had stronger perceived behavioral control for condom use, or consistently used condoms with other sex clients who were not in their support networks. At the alter level, condoms were not consistently used over spousal ties compared to other ties. Condoms were less likely to be used among alters whom ego trusted and provided emotional support. Cross-level factors (egos' attitudes toward condom use and emotional support from alters) documented a significant positive interaction on consistent condom use. Given the low frequency of condom use, future interventions should focus on mid-age FSWs and their partners within and beyond their support networks.
性传播感染(STIs)的流行已在包括中国在内的全球老年人群体中蔓延。本研究弥补了关于35岁以上中年女性性工作者(FSWs)使用避孕套的多重背景影响研究的不足。采用以自我为中心的网络设计和多层次建模相结合的方法,研究中年FSWs(自我)使用避孕套的因素及其与性伴侣(他人)的特定关系。在接受访谈的1245名中年FSWs中,73%(907名)报告称至少有一名能为自我提供社会支持的性伴侣。这在自我的支持网络中产生了总共1300条自我-他人性联系。三分之一的性联系中始终使用避孕套。在自我层面,如果自我接受过中学及以上教育、对使用避孕套有更强的行为感知控制能力,或者与不在其支持网络中的其他性客户始终使用避孕套,那么避孕套更有可能被持续使用。在他人层面,与其他关系相比,配偶关系中避孕套并非始终被使用。在自我信任并提供情感支持的他人中,避孕套使用的可能性较小。跨层次因素(自我对使用避孕套的态度以及来自他人的情感支持)对持续使用避孕套有显著的正向交互作用。鉴于避孕套使用频率较低,未来的干预措施应聚焦于中年FSWs及其支持网络内外的伴侣。
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