title: Contextual influence on condom use in commercial sex venues: A multi-level analysis among female sex workers and gatekeepers in Guangxi, China.
abstract: This study aims to assess the influence of commercial sex venues on consistent condom use among female sex workers (FSWs) and to examine associations between individual and venue level factors and consistent condom use with clients. Analysis was based on a sample of 637 FSWs and 123 gatekeepers from 51 venues in Guangxi, China. Multi-level logistic regression using Bayesian simulation via Markov Chain Monte Carlo was applied to investigate whether FSWs' individual propensity to use condom with clients was statistically dependent on the venue of working. Multi-level modeling revealed considerable variability across venues in the likelihood of consistent condom use with clients among FSWs. Characteristics at both individual and venue levels helped to explain the observed variation. Certain venue-level factors exerted their influence on condom use over and above the effect of individual-level characteristics. The contextual influence exerted on condom use behaviors among FSWs may imply a potential to harness the path to individual behaviors from a higher and more dominant level, and shed light on the design of more effective sexual risk reduction intervention among venue-based FSWs.
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT, USA. Electronic address: star.chen@uconn.edu.
authors.forename: Yiyun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Carman and Ann Adams Department of Pediatrics, Prevention Research Center, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.affiliation: Guangxi Center for Diseases Control and Prevention, Nanning, Guangxi, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Guangxi Center for Diseases Control and Prevention, Nanning, Guangxi, China.
authors.forename: Yuejiao
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Guangxi Center for Diseases Control and Prevention, Nanning, Guangxi, China.
authors.forename: Zhenzhu
authors.initials: Z
authors.lastname: Tang
authors.affiliation: Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
authors.forename: Tania B
authors.initials: TB
authors.lastname: Huedo-Medina
mesh_terms: D000293:Adolescent; D000328:Adult; D001499:Bayes Theorem; D002681:China; D017280:Condoms; D004777:Environment; D005260:Female; D006801:Humans; D016015:Logistic Models; D012307:Risk Factors; D021841:Safe Sex; D011477:Sex Work; D060386:Sex Workers; D012931:Social Environment; D055815:Young Adult
keywords: China; Condom use; Contextual influence; Sex workers