Predictors of Non-Condom Use Among Female Sex Workers in Zambia 公开

Wenson, Sunni (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/00000007x?locale=zh
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Abstract

This study examined factors that influence female sex workers decision to not use condoms with clients to prevent HIV transmission in Zambia. Specifically, personal and environmental factors were explored for associations with not using condoms with non-repeat partners. In Sub-Saharan Africa, female sex workers are 13.5 times more likely to become infected with HIV than women in the general population as a result of engaging in risk-taking behaviors. Research has identified inconsistent condom use with clients as a primary risk factor for contracting HIV. Lack of condom use can be attributed to barriers in access, low self-efficacy, and most importantly partner influence. The current study analyzed a secondary data set from the Zambia Emory HIV Research Group. A cross-sectional survey questionnaire was used to collect data on socio-demographic information, lifetime sexual history, and condom use influences among 147 female sex workers in Lusaka and Ndola, Zambia. The social cognitive theory was used to select relevant survey items as predictors of non-condom use with non-repeat partners. Results of a multivariate logistic regression revealed that female sex workers were more likely to not use a condom in the past month if the client reports being HIV-negative (AOR=0.111; p=.002; 95% CI=.028 - .438). In addition, women most commonly did not use a condom with their non-repeat partner because of higher payments and client refusal. These findings support existing literature on the powerful influence clients have over female sex workers in deciding to not use condoms. Results such as these demonstrate why female sex worker empowerment and mobilization are needed to provide supportive services and improve their ability to negotiate condom use.

Table of Contents

Table of Contents Introduction 1 Problem Justification 2 Theoretical Framework 4 Formal Statement of Problem 6 Literature Review 8 HIV Knowledge among FSW 8 Condom Use/Self-efficacy among FSW 9 Partner Influence on condom use 10 Physical Environment influence on condom use 14 Methods 18 Recruitment 18 Enrollment 19 Survey Measure 20 Outcome Variable 21 Analysis 21 Results 23 Bivariate 26 Multivariate 27 Discussion 30 Strengths and Limitations 32 Implications and Recommendations 34 References 35

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