Mitigating circumstances: A model-based analysis of associations between risk environment and infrequent condom use among Chinese street-based sex workers.
Mitigating circumstances: A model-based analysis of associations between risk environment and infrequent condom use among Chinese street-based sex workers.
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DOI：
10.1371/journal.pone.0195982
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Bouey JZH
中科院分区：
文献类型：
--
作者：
Chang RC;Hail-Jares K;Zheng H;He N;Bouey JZH
人们对自由街头性工作者在拉客时如何使用安全套知之甚少。传统的行为模型可能无法解释大多数街头性工作者工作的复杂风险环境。我们首先研究了自我效能感和不经常使用避孕套的联系，然后我们调查了客户和经常光顾的场所在这种联系中的作用。采用有目的连锁转诊抽样方法，对248名上海街头性工作者进行了调查。调查的重点是性工作者艾滋病风险因素、性工作模式、艾滋病知识和相关的艾滋病自我效能感。收集了这些商业性工作者的客户类型和行为，以及他们经常光顾的场所的特征。我们进行了一系列的多元逻辑回归模型，以探讨当客户和场所特征加入模型时，性工作者自我效能感与很少使用安全套之间的关系如何变化。我们发现，在基本模型中，低自我效能感与不经常使用避孕套有轻微相关（54.9% vs. 45.1%, AOR = 1.70, 95% CI = 0.95-3.03）。随着客户和场所特征的加入，自我效能感与安全套使用之间的关联得到加强（AOR分别为2.10 95% CI = 1.12-3.91和2.54 95% CI = 1.24-5.19）。与高收入的性工作者相比，中等收入的性工作者更有可能报告很少使用安全套（AOR = 3.92 95% CI = 1.32-11.70），而低收入和高收入的性工作者之间没有发现这种差异。访问多个场所和以外来务工人员为客户也与不经常使用安全套有关。我们的研究结果表明，性工作者的自我效能感只有在环境特征得到调整时才会影响其艾滋病毒风险行为。街头性工作者的风险环境很复杂。针对女性性工作者行为改变的规划应采用考虑风险环境的整体、多层次模型。
Little is known about how freelance street-based sex workers navigate condom use while soliciting. Traditional behavioural model may fail to account for the complex risk environment that most street-based sex workers work within. We examine first the association of self-efficacy and the infrequent condom use, then we investigated the roles of clients and venues frequented on this association. Using a purposive chain-referral sampling method, we surveyed 248 street-based sex workers in Shanghai. The survey focused on sex workers HIV risk factors, sex work patterns, HIV knowledge, and related HIV self-efficacy. Clients types and behaviours, and characteristics of the venues frequented by these commercial sex workers were also collected. We conducted a series of multiple logistic regression models to explore how the association between a sex worker’s self-efficacy with infrequent condom use change as client and venue characteristics were added to the models. We find that within the basic model, low self-efficacy was marginally associated with infrequent condom use (54.9% vs. 45.1%, AOR = 1.70, 95% CI = 0.95–3.03). As client- and venue- characteristics were added, the associations between self-efficacy and condom use were strengthened (AOR = 2.10 95% CI = 1.12–3.91 and 2.54 95% CI = 1.24–5.19 respectively). Those who reported middle-tiered income were more likely to report infrequent condom use compared to their peers of high income (AOR = 3.92 95% CI = 1.32–11.70) whereas such difference was not found between low income and high income sex workers. Visiting multiple venues and having migrant workers as clients were also associated with infrequent condom use. Our findings suggest sex worker’s self-efficacy matters in their HIV risk behaviours only when environment characteristics were adjusted. Risk environment for street-based sex workers are complex. Programming addressing behavioural changes among female sex workers should adopt holistic, multilevel models with the consideration of risk environments.
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影响因子：
5.9
作者：
Benotsch, Eric G.;Nettles, Christopher D.;Mikytuck, John J.
通讯作者：
Mikytuck, John J.
DOI：
10.1097/qai.0b013e3182968d39
发表时间：
2013-08-01
期刊：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
2.2
作者：
Hao, Chun;Liu, Hongjie;Zang, Chunpeng
通讯作者：
Zang, Chunpeng
影响因子：
2.2
作者：
Choi, Susanne Y. P.;Holroyd, Eleanor
通讯作者：
Holroyd, Eleanor