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Changes in Condom Use Behaviors Among Clients of Female Sex Workers in China
  1. Joseph Lau (jlau{at}
  1. School of Public Health, The Chinese University of Hong Kong, China
    1. Shaoping Wan
    1. Sichuan Provincial Institute for STDs and Skin Disease Prevention and Control, Chengdu, China
      1. Xiaonan Yu
      1. School of Public Health, The Chinese University of Hong Kong, China
        1. Feng Cheng
        1. China Office of Family Health International, Beijing, China
          1. Yun Zhang
          1. Management Office of China-UK HIV/AIDS Prevention and Care Project, Beijing, China
            1. Ning Wang
            1. National Center for AIDS/STDs Control and Prevention, Chinese Center for Disease Control and Prevent, China
              1. Linglin Zhang
              1. Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
                1. Jianxin Zhang
                1. School of Public Health, Sichuan University, Chengdu, China


                  Background: Clients of female sex workers (CFSWs) are at-risk for HIV transmission; relevant surveillance and interventions for this vulnerable group are scare. The China-UK HIV/AIDS Prevention and Care Project launched an enhanced intervention program involving peer education, seminars, testing services and social gatherings etc., and two behavioral surveillance studies (BSS) targeting CFSWs in Suining, Sichuan.

                  Methods: Two cross-sectional BSS (a baseline survey and an evaluative survey) were conducted in September 2005 and May 2006, respectively 356 and 372 respondents who patronized some low-end sex-services were interviewed by peer interviewers. Another triangulation condom audit exercise was conducted in June 2006.

                  Results: Prevalence of respondents utilizing at least one prevention services increased from 50.3% in 2005 to 68.5% in 2006 (adjusted OR=2.2). Respondents of the evaluative survey, as compared to their counterparts of the baseline survey, had lower prevalence of inconsistent condom users in the last 6 months (44.1% versus 77.0%, adjusted OR=0.2) and higher prevalence of condom use in the last episode of commercial sex (78.0% verus 41.5%, adjusted OR=4.9). The triangulation audit showed that condoms were used by 73.8% of CFSWs. The multivariate analysis shows that year of study (OR=0.3), self-reported STD symptoms (OR=2.9), utilization of face-to-face counseling services (OR=0.5) etc. were significantly associated with inconsistent condom use during commercial sex in the last 6 months.

                  Conclusions: Condom use and service utilization behaviors changed in the study population over a time period, when an enhanced intervention program was implemented. Such effective programs may be applied to other locations in China.

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