title: Predictors of condom use behaviors based on the Health Belief Model (HBM) among female sex workers: a cross-sectional study in Hubei Province, China.
abstract: BACKGROUND
  HIV infection related to commercial sexual contact is a serious public health issue in China. The objectives of the present study are to explore the predictors of condom use among female sex workers (FSWs) in China and examine the relationship between Health Belief Model (HBM) constructs.
  
  
  RESULTS
  A cross-sectional study was conducted in two cities (Wuhan and Suizhou) in Hubei Province, China, between July 2009 and June 2010. A total of 427 FSWs were recruited through mediators from the 'low-tier' entertainment establishments. Data were obtained by self-administered questionnaires. Structural equation models were constructed to examine the association. We collected 363 valid questionnaires. Within the context of HBM, perceived severity of HIV mediated through perceived benefits of condom use had a weak effect on condom use (r=0.07). Perceived benefits and perceived barriers were proximate determinants of condom use (r=0.23 and r=-0.62, respectively). Self-efficacy had a direct effect on perceived severity, perceived benefits, and perceived barriers, which was indirectly associated with condom use behaviors (r=0.36).
  
  
  CONCLUSIONS
  The HBM provides a useful framework for investigating predictors of condom use behaviors among FSWs. Future HIV prevention interventions should focus on increasing perceived benefits of condom use, reducing barriers to condoms use, and improving self-efficacy among FSWs.
authors.affiliation: Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China. zhaojinzhu1987@gmail.com
authors.forename: Jinzhu
authors.initials: J
authors.lastname: Zhao
authors.forename: Fujian
authors.initials: F
authors.lastname: Song
authors.forename: Shuhua
authors.initials: S
authors.lastname: Ren
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Wan
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
authors.forename: Tian
authors.initials: T
authors.lastname: Hu
authors.forename: Lydia
authors.initials: L
authors.lastname: Bazzano
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
mesh_terms: D002681:China; D017280:Condoms; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016013:Likelihood Functions; D012044:Regression Analysis; D021841:Safe Sex / Q000706:statistics & numerical data; D020377:Self Efficacy; D011477:Sex Work; D060386:Sex Workers; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires