Morris M, Pramualratana A, Podhisita C, Wawer M J
Department of Sociology, Columbia University, New York, New York 10027, USA.
AIDS. 1995 May;9(5):507-15.
To analyze the extent and determinants of condom use with commercial sex partners among lower socioeconomic status groups in the Thai population.
Respondents were sampled in Udon Thani, Saraburi and Bangkok in 1992. Completed sample size was 678 women in brothels, 330 male truck drivers and 1,075 men aged 17-45 years. Behavioral data and local sexual network information were collected using structured questionnaires (face-to-face interviews), focus groups and in-depth unstructured interviews.
Data were analyzed using univariate and multivariate logistic regression.
Condom use with commercial partners remains inconsistent. Consistent use was reported by 61% of women in brothels, 25% of truck drivers, and 29% of men in the low-income population. The single strongest predictor of consistent condom use for all groups is type of partnership. Consistent use drops significantly with regular (multivisit) commercial sex partners compared with casual (single visit) commercial partners; adjusted odds of consistent use are 0.22 for women and 0.25 for men. Brothel women report that one in five of their commercial partners is a 'regular', and 20% of the young men who report a commercial partner report a 'regular'.
The strongest determinant of consistent condom use is the nature of the relational bond between the partners, rather than their individual characteristics, knowledge or attitudes. To raise condom use further, programs will have to move beyond the standard knowledge-attitudes-practices paradigm focus on individual attributes to address the contextual determinants of behavior.
分析泰国社会经济地位较低群体中与商业性伙伴使用避孕套的程度及影响因素。
1992年在乌隆他尼、沙拉武里和曼谷对受访者进行抽样。完整样本包括678名妓院女性、330名男性卡车司机以及1075名年龄在17 - 45岁的男性。通过结构化问卷（面对面访谈）、焦点小组和非结构化深入访谈收集行为数据及当地性网络信息。
使用单变量和多变量逻辑回归分析数据。
与商业性伙伴使用避孕套的情况仍不一致。妓院中61%的女性、25%的卡车司机以及低收入人群中29%的男性报告始终坚持使用避孕套。对所有群体而言，始终坚持使用避孕套的最强单一预测因素是性伙伴关系类型。与临时（单次拜访）商业性伙伴相比，与固定（多次拜访）商业性伙伴使用避孕套的比例显著下降；经调整后，女性始终坚持使用避孕套的几率为0.22，男性为0.25。妓院女性报告称，她们五分之一的商业性伙伴是“固定的”，而报告有商业性伙伴的年轻男性中有20%称有“固定”伙伴。
始终坚持使用避孕套的最强决定因素是性伙伴之间关系纽带的性质，而非其个人特征、知识或态度。为进一步提高避孕套的使用率，相关项目必须超越关注个人属性的标准知识 - 态度 - 行为范式，转而关注行为的背景决定因素。
