Rugpao S, Tovanabutra S, Beyrer C, Nuntakuang D, Yutabootr Y, Vongchak T, de Boer M A, Celentano D D, Nelson K E
Faculty of Medicine, Chiang Mai University, Thailand.
Sex Transm Dis. 1997 Oct;24(9):546-9. doi: 10.1097/00007435-199710000-00010.
BACKGROUND AND OBJECTIVE: In an investigation of condom breakage in commercial sex, we found a high proportion of multiple condoms use. This study sought to ascertain the characteristics of brothel-based commercial sex workers (CSWs) and their clients; to identify the decision makers (clients and/or CSWs) active in choosing multiple condom use; and to determine whether there is an implicit hierarchy of condom use negotiation. GOALS: To identify factors associated with multiple condom use in commercial sex and to provide an understanding of how this innovation developed in this setting. STUDY DESIGN: Sixty-seven brothel-based CSWs in Lamphun Province who participated in a study of condom breakage participated in a case-control study of multiple versus single condom use, which determined CSW and client characteristics for evidence of multiple condom use. Interviews and focus groups were used to determine decision making for condom use and the contexts for multiple use. Association between characteristics of CSWs/clients and multiple condom use was analyzed using X2 for trend. RESULTS: No official program encouraged multiple condom use; this appeared to be a community-devised strategy to increase protection from human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). CSWs working in daytime brothels had significantly greater multiple condom use than those working in nighttime brothels; mean percentages + SD of multiple simultaneous use were 57.5% + 28.6 and 35.5% + 22.4, respectively (p < 0.001). Day CSWs were older, had more pregnancies, reported higher frequency of STD symptoms and history of pelvic inflammatory disease, and had more clients per day but had a lower number of sex acts per client than night CSWs. Among factors associated with multiple condoms, only age was significant. The decision to use single or multiple condoms for a sex act was primarily (78.2% in single and 79.3% in multiple) made by the CSW herself. The main reason given for multiple condom use was protection from HIV/STD. CONCLUSIONS: There is high compliance between CSWs in Lamphun province and the Ministry of Public Health-sponsored 100% condom use campaign, and CSWs are attempting to further reduce their risks of HIV/STD exposure by using multiple condoms for sex with their clients.
背景与目的：在一项关于商业性行为中避孕套破裂情况的调查中，我们发现使用多个避孕套的比例很高。本研究旨在确定妓院中商业性工作者（CSW）及其客户的特征；找出积极选择使用多个避孕套的决策者（客户和/或CSW）；并确定在避孕套使用谈判中是否存在隐含的等级制度。 目标：确定与商业性行为中使用多个避孕套相关的因素，并了解这种做法在该环境中是如何形成的。 研究设计：南奔府参与避孕套破裂研究的67名妓院CSW参与了一项关于使用多个避孕套与使用单个避孕套的病例对照研究，该研究确定了CSW和客户的特征，以寻找使用多个避孕套的证据。通过访谈和焦点小组来确定避孕套使用的决策以及多次使用的背景情况。使用X2趋势分析来分析CSW/客户特征与使用多个避孕套之间的关联。 结果：没有官方项目鼓励使用多个避孕套；这似乎是一种社区制定的策略，以增强对人类免疫缺陷病毒（HIV）和其他性传播疾病（STD）的防护。在白天妓院工作的CSW使用多个避孕套的比例显著高于在夜间妓院工作的CSW；同时使用多个避孕套的平均百分比±标准差分别为57.5%±28.6和35.5%±22.4（p<[0.001]）。白天的CSW年龄更大，怀孕次数更多，报告的STD症状频率更高，有盆腔炎病史，每天的客户更多，但每位客户的性行为次数比夜间CSW少。在与使用多个避孕套相关的因素中，只有年龄具有显著性。性行为中使用单个或多个避孕套的决定主要由CSW自己做出（单个避孕套使用情况中占78.2%，多个避孕套使用情况中占79.3%）。使用多个避孕套的主要原因是预防HIV/STD。' 结论：南奔府的CSW对公共卫生部发起的100%使用避孕套运动的依从性很高，并且CSW试图通过与客户发生性行为时使用多个避孕套来进一步降低感染HIV/STD的风险。
J Acquir Immune Defic Syndr Hum Retrovirol. 1997-2-1
J Acquir Immune Defic Syndr Hum Retrovirol. 1998-7-1
BMC Public Health. 2011-12-29
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