Background Condom promotion was primarily to prevent human immunodeficiency virus (HIV) among Chinese female sex workers (FSWs), which may have missed to improve their reproductive health and sexual health holistically. A more complete understanding of FSWs’ sexual and reproductive health needs specifically pertaining to the choice of contraceptive would be beneficial to make progress in disease control. This study aimed to better characterize contraceptive use and explore the interaction between contraception and condom use among Chinese FSWs.
Methods A cross-sectional study was conducted in eight cities throughout 7 provinces in China, 2019. Participants completed a survey including sociodemographic information, sexual behaviors and reproduction measures. The exposure of interest was non-barrier contraceptive use, and the outcome of interest was inconsistent condom use with clients. Multivariate logistic regression and subgroup analysis were conducted to assess the relationship between non-barrier contraceptive use and condom use among Chinese FSWs.
Results In total, 1229 FSWs participated in the study with a median age of 35 years. 629(51.2%) women reported using non-barrier contraceptives while 586 (47.7%) used barrier contraceptives. Odds of inconsistent condom use was higher (aOR=1.24, 95% CI: 0.99–1.57) among non-barrier contraceptives users than among barrier contraceptives users, but it lacks statistical significance. However, for women in middle-tier venues (aOR=0.66, 95% CI: 0.46–0.96), upper-tier venues (aOR=1.64, 95% CI: 1.14–2.36), and those who completed senior high school or above (aOR=4.07, 95% CI: 2.20–7.52), we observed correlation between inconsistent condom use and non-barrier contraception.
Conclusion We observed that non-barrier contraceptive users who work in upper tier settings and with higher educational attainment tend to use condom inconsistently. Condom promotion efforts currently focused on HIV and STI prevention among FSWs in China would benefit from considering the contraceptive and reproductive needs of this population.
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