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Determinants of consistent condom use among female commercial sex workers in the Democratic Republic of Congo: implications for interventions

Abstract

Objective: To identify correlates of consistent condom use among commercial sex workers (CSW) over a four-week period.

Methods: A total of 2638 CSW selected in all the provincial capital cities in the Democratic Republic of Congo using the time location sampling technique were interviewed to collect information on sociodemographic data, sexual history and behaviour, consumption of intoxicants (alcohol and drugs), knowledge of condoms, their accessibility and the pattern of their use over a four-week period, and exposure to HIV/AIDS prevention services.

Results: 40% (95% CI 38.1 to 41.8) of the CSW have used condoms consistently and this pattern differed according to the category of sexual partners (61.4% in the case of paying partners and 38.2% in the case of non-paying partners). Consistent condom use was associated with age, those aged 20–44 years were more likely to be consistent users (OR 1.34, 95% CI 1.06 to 1.69), having cited it as a prevention means for HIV (OR 2.88, 95% CI 2.09 to 3.96), less time in commercial sex work, higher number of clients (OR 3.83, 95% CI 2.95 to 4.96), exposure to voluntary counselling and testing (VCT; OR 2.02, 95% CI 1.70 to 2.42), and access to condoms (OR 1.51, 95% CI 1.25 to 1.82).

Conclusions: The risk perception bias associated with non-paying partners, time as a commercial sex worker and age should be taken into account when planning interventions targeting CSW. Access to condoms and VCT should be improved because they are likely to impact on behaviour.

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