title: Prevalence and associated factors of condom use during commercial sex by female sex workers who were or were not injecting drug users in China.
abstract: OBJECTIVE
  We compared the prevalence of inconsistent condom use during commercial sex between female sex workers (FSWs) who did or did not inject drugs (FSW-IDUs and FSW-NIDUs) and investigated factors associated with this inconsistent use within these two groups.
  
  
  METHODS
  Some 158 FSW-NIDUs recruited from sex work venues and 218 FSW-IDUs recruited via the snowball sampling method were interviewed anonymously.
  
  
  RESULTS
  Only 16.5% of the FSW-IDUs and 51.3% of the FSW-NIDUs had used condoms consistently during commercial sex in the last month (odds ratio (OR)=0.19). Factors significantly associated with inconsistent condom use in both groups included: behavioural intention for condom use (adjusted odds ratio (AOR)=0.05 and 0.13), condom unavailability (AOR=4.77 and 5.33), a perceived need to engage in unprotected sex if the client paid more (AOR=8.74 and 10.84) or insisted on demanding unprotected sex (AOR=19.78 and 7.59), and submissive gender power (AOR=11.65 and 2.58). One factor, perceived susceptibility (AOR=2.64), was significant only among FSW-NIDUs, whereas perceived efficacy of condom use in preventing HIV transmission (AOR=0.08), perceptions that peer FSWs would not use condoms with clients (AOR=2.23), self-hatred (AOR=2.25) and lack of social support (AOR=2.93) were significant only among FSW-IDUs. Injecting with used syringes was also associated with inconsistent condom use among FSW-IDUs (AOR=4.64).
  
  
  CONCLUSIONS
  FSW-IDUs were more likely than FSW-NIDUs to possess the cognitive and psychosocial conditions associated with unprotected commercial sex. Interventions need to take these differences into account.
authors.affiliation: School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong. jlau@cuhk.edu.hk
authors.forename: Joseph T F
authors.initials: JT
authors.lastname: Lau
authors.forename: Jing
authors.initials: J
authors.lastname: Gu
authors.forename: Hi Yi
authors.initials: HY
authors.lastname: Tsui
authors.forename: Hongyao
authors.initials: H
authors.lastname: Chen
authors.forename: Eleanor
authors.initials: E
authors.lastname: Holroyd
authors.forename: Renfan
authors.initials: R
authors.lastname: Wang
authors.forename: Xianyou
authors.initials: X
authors.lastname: Hu
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*