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J Acquir Immune Defic Syndr. 2009 May 1;51 Suppl 1:S42-6. doi: 10.1097/QAI.0b013e3181a265b2.

Predictors of sexual risk reduction among Mexican female sex workers enrolled in a behavioral intervention study.

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1
Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0680, USA.

Abstract

OBJECTIVE:

We recently showed efficacy of an intervention to increase condom use among female sex workers (FSWs) in Tijuana and Ciudad Juarez, situated on the Mexico-United States border. We determined whether increases in condom use were predicted by social cognitive theory and injection drug user status among women randomized to this intervention.

METHODS:

Four hundred nine HIV-negative FSWs aged >or=18 years having unprotected sex with clients within the prior 2 months received a brief individual counseling session integrating motivational interviewing and principles of behavior change (ie, HIV knowledge, self-efficacy for using condoms, and outcome expectancies).

RESULTS:

Increases in self-efficacy scores were associated with increases in percent condom use (P = 0.008), whereas outcome expectancies were not. Female sex workers who inject drugs (FSW-IDUs) increased condom use with clients but not to the same extent as other FSWs (P = 0.09). Change in HIV knowledge was positively associated with change in percent condom use among FSW-IDUs (P = 0.03) but not noninjection drug users.

CONCLUSIONS:

Increases in self-efficacy significantly predicted increased condom use among FSWs, consistent with social cognitive theory. Increased HIV knowledge was also important among FSW-IDUs, but their changes in condom use were modest. Enhanced interventions for FSW-IDUs are needed, taking into account realities of substance use during sexual transactions that can compromise safer sex negotiation.

PMID:
19384101
PMCID:
PMC2734908
DOI:
10.1097/QAI.0b013e3181a265b2
[Indexed for MEDLINE]
Free PMC Article
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