274051 Correlates of self-efficacy for condom use among male clients of female sex workers

Tuesday, October 30, 2012

Tyson Volkmann, MPH , Joint Doctoral Program in Public Health (Global Health), San Diego State University/University of California, San Diego, San Diego
Shirley J. Semple, PhD , Department of Psychiatry, University of California, San Diego, La Jolla, CA
Claudia Chavarin, MD , Department of Psychiatry, University of California, San Diego, La Jolla, CA
Karla D. Wagner, PhD , Division of Global Public Health, University of California San Diego, San Diego, CA
Carlos Magis-Rodriguez, MD , Clínica Especializada Condesa / Programa de VIH/SIDA de la Ciudad de México, Consorcio de Investigacion Sobre VIH/SIDA/TB, Ciudad de Mexico, Mexico
Steffanie Strathdee, PhD , 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
Introduction: In Tijuana, Mexico, male clients (MCs) of female sex workers (FSWs) engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain unstudied in MCs. We examined these correlates in MCs of FSWs in Tijuana. Methods: Eligible MCs were ≥18 years of age, HIV-negative, lived in Tijuana or San Diego, CA, reported unprotected sex with a Tijuana FSW ≥1 time in the past four months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed a questionnaire including demographics, substance use, psychosocial/psychosexual characteristics, sexual behaviors, and underwent HIV/STI testing. Likert scale-scored psychometric measures included outcome expectancies for negotiation of safe sex, social support, and sexual sensation seeking. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Results: Of 393 MCs, mean age was 38 years and mean years of education was 9.3. Participants were mostly Latino (85.2%), Spanish speaking (92.4%), and employed (61.6%). Factors independently associated with higher self-efficacy for condom use were not speaking Spanish (β=-0.14;p=0.005), number of STIs since sexual debut (β=0.13 per-unit increase; p=0.049), higher outcome expectancies for negotiation of safe sex (β=0.40 per-unit increase; p<0.001), lower sexual sensation seeking (β=-0.14 per-unit increase; p=0.031), and higher social support (β=0.17 per-unit increase; p=0.002). Discussion: These results highlight important psychosocial and psychosexual correlates of self-efficacy for condom use to consider when designing socio-cognitive sexual behavioral risk-reduction interventions (e.g., increasing condom use) in populations with high risk for HIV/STI transmission.

Learning Areas:
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research

Learning Objectives:
Discuss the importance of examining correlates of self-efficacy for condom use among male clients of female sex workers in Tijuana, Mexico. List correlates of self-efficacy for condom use among male clients of female sex workers in Tijuana, Mexico. Explain how psychosocial and psychosexual correlates of self-efficacy for condom use fit into existing behavioral change theoretical frameworks. Discuss how socio-cognitive correlates of self-efficacy for condom use can be used to inform sexual behavioral risk reduction interventions among populations at high-risk for HIV/STI transmission.

Keywords: HIV Risk Behavior, Vulnerable Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral candidate working on HIV/STI prevention research in the US border region, which is the focus of my dissertation. I have conducted research in this region for the last four years, and have become highly familiar with the at-risk populations and their needs.
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.

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