A cross-sectional study to evaluate factors related to condom use with commercial sexual partners in workers from Ecuadorian companies.
BACKGROUND
Unprotected intercourse with sex workers is one of the major risk factors for HIV infection. Consistent condom use is a prerequisite to lower the incidence of HIV.


METHODS
We assessed the prevalence of condom use and its determinants among company workers engaged with commercial sexual partners in Ecuador. The study was based on a random sample of 115 companies and 1,732 workers stratified by province and working sector and utilized the "Behavioral Surveillance Surveys - Adult questionnaire" developed by Family Health International.


RESULTS
Of the 1,561 sexually active workers, 311 (19.9%) reported having intercourse with sex workers. Among them 25.9% did not use a condom at the last sexual intercourse. As for condom use frequency over the last 12 months, 29/208 (13.9%) reported never, 23 (11.1%) sometimes, 24 (11.5%) almost every time and 132 (63.5%) every time. Factors adversely affecting condom use frequency over the last 12 months were female gender (OR = 4.56, 95% CI: 1.45-14.4), older age (OR = 1.07, 95% CI: 1.03-1.10), low educational level (OR = 4.69, 95% CI: 1.95-11.3) and married workers living with spouse (OR = 7.66, 95 % CI: 3.08-19.1). By contrast, factors such as age at first sexual intercourse, job category, HIV transmission and prevention measure knowledge, single workers, previous exposure to HIV intervention programs and having a casual sexual partner were not affecting condom use frequency. When considering condom use during the last sexual intercourse or during the past 12 months with commercial sexual partners, results were similar.


CONCLUSIONS
Workers with low education, older age, female gender and those married living with their spouse should be targeted for specific educational interventions.
Public Health Department, University of Liège, Liège, Belgium. mariadelcarmencg@yahoo.com.|Medical School, Pontifical Catholic University, Quito, Ecuador. mariadelcarmencg@yahoo.com.
María C
MC
Cabezas
Translational Research Center, Universidad de las Américas (UDLA), Quito, Ecuador. mfornasini@udla.edu.ec.
Marco
M
Fornasini
Public Health Department, University of Liège, Liège, Belgium. ndardenne@ulg.ac.be.
Nadia
N
Dardenne
Accreditation Canada International, Ottawa, Canada. davidbarmettler@yahoo.com.
David
D
Barmettler
Psychology School, Universidad San Francisco de Quito (USFQ), Cumbaya, Ecuador. tborja@usfq.edu.ec.
Teresa
T
Borja
Public Health Department, University of Liège, Liège, Belgium. aalbert@ulg.ac.be.
Adelin
A
Albert
D000328:Adult; D000367:Age Factors; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004484:Ecuador; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007221:Industry; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D060386:Sex Workers / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012959:Socioeconomic Factors