Condom Use Among Female Sex Workers in China: Role of Gatekeepers

The researchers sought to study the potential role of establishment gatekeepers in China in promoting condom use among female sex workers (FSWs). They set out to evaluate FSWs' perceptions of gatekeepers' attitudes and their support for condom use and to assess their relationship with FSWs' perceptions, knowledge and practice related to proper condom use. To accomplish this, they conducted a cross-sectional study among 454 establishment-based FSWs in one Chinese county.

Among FSWs, perceived gatekeeper support for condom use was low. Perceived support for condom use was positively associated with condom use communication with sexual partners, condom use frequency and intention; however, it was not associated with proper condom use among FSWs. Perceived support was significantly associated with most condom-use perceptions -- such as self-efficacy of condom use, condom use barriers and perceived peer condom use -- among FSWs.

The results led the researchers to recommend that health care professionals "work with gatekeepers to create a supportive local environment for condom use in sex work establishments. Gatekeepers need to clearly articulate their support for condom use to the FSWs." They also noted the need for training and skill acquisition regarding correct condom use among FSWs.

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