title: The use of structural equation modelling and behavioural theory to target priority interventions to increase condom use among the intimate partners of sex workers in French Guiana.
abstract: French Guiana is the French overseas territory that is most affected by HIV. Sex work seems to be an important driver of the epidemic. Although female sex workers are informed by local NGOs, they still have risky behaviours, including not using condoms with their intimate partner despite knowing HIV is highly prevalent. The objective of this study was to find intervention targets on this specific behaviour. For this, a structural equation model (SEM) was built using assumptions from behavioural theories. Behaviour theories attempt to connect research and practice. Within the health belief model framework, perceived threats, perceived benefits, and self-perceived efficacy were tested. Vulnerability was added because of the particular context of French Guiana. The results highlight that female sex workers' perceived self-efficacy was central in condom use with the intimate partner (with a significant correlation coefficient of 0.52 in the SEM). The perceived self-efficacy was strongly influenced by sociodemographic factors, particularly by nationality. Female sex workers from Brazil seemed to be more comfortable about asking their intimate partner to use condoms (OR: 7.81; CI: 1.87-32.63) than sex workers of other nationalities. These results emphasize that prevention interventions for female sex workers should emphasize their empowerment.
authors.affiliation: a INSERM CIC 1424, Cayenne General Hospital , Cayenne , French Guiana.
authors.forename: Marie-Claire
authors.initials: MC
authors.lastname: Parriault
authors.affiliation: a INSERM CIC 1424, Cayenne General Hospital , Cayenne , French Guiana.
authors.forename: Astrid
authors.initials: A
authors.lastname: Van Melle
authors.affiliation: a INSERM CIC 1424, Cayenne General Hospital , Cayenne , French Guiana.
authors.forename: Célia
authors.initials: C
authors.lastname: Basurko
authors.affiliation: b COREVIH Guyane, Cayenne General Hospital , Cayenne , French Guiana.
authors.forename: Leila
authors.initials: L
authors.lastname: Adriouch
authors.affiliation: a INSERM CIC 1424, Cayenne General Hospital , Cayenne , French Guiana.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Rogier
authors.affiliation: c Department of Dermatology , Cayenne General Hospital , Cayenne , French Guiana.
authors.forename: Pierre
authors.initials: P
authors.lastname: Couppié
authors.affiliation: a INSERM CIC 1424, Cayenne General Hospital , Cayenne , French Guiana.|b COREVIH Guyane, Cayenne General Hospital , Cayenne , French Guiana.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000208:ethnology; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D005616:French Guiana; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D007398:Interpersonal Relations; D008960:Models, Psychological; D011209:Power, Psychological; D012309:Risk-Taking; D021841:Safe Sex / Q000208:ethnology*; D020377:Self Efficacy; D060386:Sex Workers / Q000523:psychology*; D012747:Sexual Partners; D055815:Young Adult
keywords: Female sex workers; HIV; behavioural theories; condom use; structural equation modelling