The relational determinants of condom use with commercial sex partners in Thailand.
OBJECTIVE
To analyze the extent and determinants of condom use with commercial sex partners among lower socioeconomic status groups in the Thai population.


METHODS
Respondents were sampled in Udon Thani, Saraburi and Bangkok in 1992. Completed sample size was 678 women in brothels, 330 male truck drivers and 1,075 men aged 17-45 years. Behavioral data and local sexual network information were collected using structured questionnaires (face-to-face interviews), focus groups and in-depth unstructured interviews.


METHODS
Data were analyzed using univariate and multivariate logistic regression.


RESULTS
Condom use with commercial partners remains inconsistent. Consistent use was reported by 61% of women in brothels, 25% of truck drivers, and 29% of men in the low-income population. The single strongest predictor of consistent condom use for all groups is type of partnership. Consistent use drops significantly with regular (multivisit) commercial sex partners compared with casual (single visit) commercial partners; adjusted odds of consistent use are 0.22 for women and 0.25 for men. Brothel women report that one in five of their commercial partners is a 'regular', and 20% of the young men who report a commercial partner report a 'regular'.


CONCLUSIONS
The strongest determinant of consistent condom use is the nature of the relational bond between the partners, rather than their individual characteristics, knowledge or attitudes. To raise condom use further, programs will have to move beyond the standard knowledge-attitudes-practices paradigm focus on individual attributes to address the contextual determinants of behavior.
Morris
M
M
Department of Sociology, Columbia University, New York, New York 10027, USA.
Pramualratana
A
A
Podhisita
C
C
Wawer
M J
MJ
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D001294:Attitude to Health; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D011477:Sex Work; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D013785:Thailand