Consistent Condom Use among Sex Workers in Nigeria
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Objectives: This study examines factors influencing consistent condom use among sex
workers in Nigeria. Such information can help improve the design of intervention
campaigns to reduce the spread of HIV among high-risk groups and the general
population.
Methods: We used a nationally representative sample of 2,578 sex workers collected in
1998. This study uses logistic regression to predict the effect of exposure to advertising
for “Gold Circle” and “Cool” brand condoms (two popular social marketed brands),
knowledge of HIV transmission, number of regular partners, self-efficacy, risk
perception, and demographic variables on consistency of condom use.
Results: The findings suggest that most sex workers lived in urban (84%) areas, were
below age 30 (74%), and over half had secondary or higher education (55%). Most
respondents had been involved in sex work for two or less years (73%) and had a
regular partner (72%). Although the majority of sex workers were worried about AIDS
(81%), only 55% reported consistent condom use in the last five sex acts. Among sex
workers who usually asked clients to use condoms, 76 percent used condoms in the last
five sex acts, compared to 8% of those who do not ask all clients to use condoms. After
controlling for background variables and other factors, multivariate results suggested
that sex workers who had been exposed to two or more sources of advertising for “Gold
Circle” and “Cool” condom brands were about two times more likely to consistently use
condoms than those who did not see any advertisements (p < 0.001). Sex workers who
knew of two or more modes of HIV transmission were 44% more likely to consistently
use condoms than those who had no knowledge (p < 0.05). Sex workers who worried
about contracting HIV were two times more likely to consistently use condoms than
those who were not worried (p < 0.001). The most important predictor of consistent
condom use was self-efficacy. Sex workers who asked all their clients to use condoms
were 39 times more likely to consistently use condoms than those who did not ask all
their clients to use condoms.
Conclusions: Program interventions that use multiple communication media to increase
condom brand awareness, to provide information about the modes of HIV transmission
and its consequences, and to increase self-efficacy can help improve consistency of
condom use among Nigerian sex workers. This may reduce the likelihood of HIV
transmission to other populations.
Keywords
H Social Sciences (General), HB Economic Theory, HC Economic History and Conditions