207778 Condom Access: Associations with Consistent Condom Use among Female Sex Workers in two Northern Border Cities of México

Monday, November 9, 2009

Fátima A. Muñoz, MD MPH , Division of Global Public Health, University of California, San Diego, La Jolla, CA
Robin A. Pollini, PhD MPH , Division of Global Public Health, University of California San Diego, La Jolla, CA
María Luisa Zúñiga, PhD , Division of Global Public Health, University of California, San Diego, La Jolla, CA
Steffanie Strathdee, PhD , Division of Global Public Health, University of California, San Diego, La Jolla, CA
Maria Remedios Lozada, Dra , Patronato Pro-COMUSIDA, Tijuana, Mexico
Gustavo A. Martinez, Dr , Salud y Desarrollo Comunitario de Ciudad Juarez, A.C.; Federación Méxicana de Asociaciones Privadas, Ciudad Juarez, Mexico, Ciudad Juarez, Chihuahua, Mexico
Ana M. Valles-Medina, MPH , Master in Public Health Program, Universidad Autonoma de Baja California, Tijuana, Baja California, Mexico
Nicole Sirotin, MD , Division of Global Public Health, University of California San Diego, La Jolla, CA
Thomas Patterson, PhD , Dept of Psychiatry, University of California, La Jolla, CA
BACKGROUND:

Many female sex workers (FSWs) on Mexico's northern border do not report consistent condom use. We explored associations between condom access and condom use among FSWs in Tijuana and Ciudad Juarez, Mexico.

METHODS:

FSWs who reported unprotected sex with more than one client in the past four months were recruited between 2004-2006 and underwent interviewer-administered interviews. Logistic regression was used to explore factors associated with consistent condom use (often/always vs. sometimes/never) during vaginal sex within the prior month.

RESULTS:

Of 924 FSWs, 56% reported consistent condom use. Most (74%) reported that condoms were available; 69% could afford condoms and 48% had received free condoms. FSWs who had condoms available (87% vs 62%, p<0.001) and could afford to buy their own condoms (79% vs 65%, p<0.001) were more likely to report consistent condom use. Factors independently associated with consistent condom use were condom availability (AdjOR=2.21; 95%CI: 1.44-3.41) and being able to afford condoms (AdjOR=1.57; 95%CI: 1.12-2.20). Factors independently but inversely associated with condom use included poor financial status (AdjOR=0.65; 95%CI: 0.47-0.90), methamphetamine use (AdjOR=0.58; 95%CI:0.40-0.83), alcohol use (AdjOR=0.68; 95%CI: 0.49-0.96) and recent injection drug use (AdjOR=0.62; 95%CI: 0.39-0.97).

CONCLUSIONS

Greater condom availability and affordability were associated with consistent condom use, but poor financial status, methamphetamine use, and injection drug use were related to inconsistent condom use. Prevention strategies to reduce the sexual transmission of HIV/STIs among FSWs should promote condom access, and drug-related risk reduction strategies.

Learning Objectives:
1.Identify the factors that influence to safe sex 2.Discuss the negative impact of the use of illegal drugs and the socio-economic conditions of female sex workers who have unprotected sexual practices 3.Understanding the complexity and dynamics of FSWs in Tijuana and Ciudad Juarez

Keywords: Condom Use, Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the primary author
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Women and HIV: Emerging Issues
See more of: HIV/AIDS