Understanding the Dynamics of Condom Use Among Female Sex Workers in China

The current study examines "the complex relationships between multiple levels of determinant factors of condom use with clients among female sex workers in China" through the use of "a hypothesized theoretical model that combines concepts from the health belief model and social cognitive theory."

In a rural county of Guangxi in 2004, data were collected through the baseline survey of an HIV prevention project among 454 establishment-based female sex workers. Path analysis was performed to test the hypothesized model that specifies relationships between all observed variables.

Within the context of the model, STD/HIV knowledge and condom use skills were related to self-efficacy, which in turn related to condom use. Susceptibility/severity was related to perceived benefits of unprotected sex, while perceived benefits were in turn inversely related to condom use. Their effects on condom use were mediated by self-efficacy and perceived benefits. Self-efficacy was not associated with perceived benefits of unprotected sex, but perceived support at the establishment level was positively related to condom use.

"Self-efficacy, perceived benefits of unprotected sex, and perceived establishment-level support are proximate determinants of condom use among female sex workers," the authors concluded. "Future HIV prevention interventions should integrate these factors into conceptual frameworks."