Perceived control over condom use among sex workers in Madagascar: a cohort study.
BACKGROUND
Women's perceived control over condom use has been found to be an important determinant of actual condom use in some studies. However, many existing analyses used cross-sectional data and little quantitative information exists to characterize the relationships between perceived control and actual condom use among sex worker populations.


METHODS
We assessed the association between measures of perceived condom use control and self-reported use of male condoms employing data from a longitudinal pilot study among 192 sex workers in Madagascar.


RESULTS
In multivariable models, a lack of perceived control over condom use with a main partner and having a main partner ever refuse to use a condom when asked were both associated with an increased number of sex acts unprotected by condoms in the past week with a main partner (RR 1.86; 95% CI 1.21-2.85; RR 1.34; 95% CI 1.03-1.73, respectively). Conversely, no measure of condom use control was significantly associated with condom use with clients.


CONCLUSIONS
Perceived control over condom use was an important determinant of condom use with main partners, but not clients, among sex workers in Madagascar. Programs working with sex workers should reach out to main and commercial partners of sex workers to increase male condom use.
Pettifor
Audrey
A
Department of Epidemiology, University of North Carolina, Chapel Hill, USA. apettif@email.unc.edu
Turner
Abigail Norris
AN
Swezey
Teresa
T
Khan
Maria
M
Raharinivo
Mbolatiana S M
MS
Randrianasolo
Bodo
B
Penman-Aguilar
Ana
A
Van Damme
Kathleen
K
Jamieson
Denise J
DJ
Behets
Frieda
F
D000328:Adult; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008270:Madagascar / Q000453:epidemiology; D012309:Risk-Taking; D021841:Safe Sex / Q000706:statistics & numerical data; D011477:Sex Work / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D014931:Women, Working / Q000706:statistics & numerical data*; D055815:Young Adult