An exploration of contextual factors that influence HIV risk in female sex workers in Mexico: The Social Ecological Model applied to HIV risk behaviors

• Published in: AIDS care 2009-10, Vol.21 (10), p.1335-1342
• Main Authors: Larios, Sandra E., Lozada, Remedios, Strathdee, Steffanie A., Semple, Shirley J., Roesch, Scott, Staines, Hugo, Orozovich, Prisci, Fraga, Miguel, Amaro, Hortensia, de la Torre, Adela, Magis-Rodríguez, Carlos, Patterson, Thomas L.
• Format: Article
• Language: English
• Subjects: Adult; AIDS/HIV; Biological and medical sciences; condom use; Condoms; Condoms - statistics & numerical data; Disease prevention; Ecological models; Female; Fundamental and applied biological sciences. Psychology; HIV; HIV Infections - psychology; HIV risk; Human immunodeficiency virus; Human viral diseases; Humans; Income; Infectious diseases; Medical sciences; Mexico; Personality. Affectivity; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Risk-Taking; Safe sexual practices; Self Efficacy; Sex industry; Sex Work; sex workers; Sexual behavior; Sexuality. Sexual behavior; Social Ecological Model; Studies; Unsafe Sex - psychology; Unsafe Sex - statistics & numerical data; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Women; Womens health
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540120902803190

The present study examined the applicability of the Social Ecological Model for explaining condom use in a sample of female sex workers (FSWs) (N=435) participating in a behavioral intervention to increase condom use in Tijuana, Mexico. Using a multigroup path analysis, we compared women who work in bar settings (n=233) to those who worked on the street (n=202) with regard to an individual factor (self-efficacy), an interpersonal factor (client financial incentives), and a structural factor (condom access). Competing models showed differential impacts of these factors in the two venue-based groups. Having access to condoms was associated with greater self-efficacy and less unprotected sex in women who worked in bars. Among street-based FSWs, having clients offer monetary incentives for unprotected sex was related to greater unprotected sex, while having access to condoms was not. Understanding the contextual factors associated with condom use among subgroups of FSWs has important implications for the development of HIV prevention interventions.