title: Perceived control over condom use among sex workers in Madagascar: a cohort study.
abstract: 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.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, USA. apettif@email.unc.edu
authors.forename: Audrey
authors.initials: A
authors.lastname: Pettifor
authors.forename: Abigail Norris
authors.initials: AN
authors.lastname: Turner
authors.forename: Teresa
authors.initials: T
authors.lastname: Swezey
authors.forename: Maria
authors.initials: M
authors.lastname: Khan
authors.forename: Mbolatiana S M
authors.initials: MS
authors.lastname: Raharinivo
authors.forename: Bodo
authors.initials: B
authors.lastname: Randrianasolo
authors.forename: Ana
authors.initials: A
authors.lastname: Penman-Aguilar
authors.forename: Kathleen
authors.initials: K
authors.lastname: Van Damme
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.forename: Frieda
authors.initials: F
authors.lastname: Behets
mesh_terms: 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