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首页> 外文期刊>AIDS care. >Social and structural factors increase inconsistent condom use by sex workers' one-time and regular clients in Northern Uganda
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Social and structural factors increase inconsistent condom use by sex workers' one-time and regular clients in Northern Uganda

机译：社会和结构因素在乌干达北部的性工作者的一次性和普通客户增加了不一致的避孕套

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While sex workers (SWs) bear the brunt of the epidemic in Uganda, there remains a dearth of empirical research on the structural drivers of HIV prevention among SWs. This study examined the drivers of inconsistent condom use by one-time and regular clients of young women SWs in Gulu, Northern Uganda. Data were drawn from the Gulu Sexual Health Study, a cross-sectional study of young SWs, aged 14 years and older (2011-2012). SWs were recruited using peer/SW-led outreach, in partnership with The AIDS Support Organization and other CBOs. Multivariable logistic regression was used to examine the correlates of inconsistent condom use by one-time and regular clients. In total, 84.5% of the 381 SWs servicing regular clients and 76.8% of the 393 SWs servicing one-time clients reported inconsistent client condom use. In multivariable analysis, physical/sexual violence by clients (AOR=5.39; 95%CI 3.05-9.49), low sexual control by workers (measured by the validated Pulweritz scale) (AOR=2.86; 95%CI 1.47-5.58), alcohol/drug use while working (AOR=1.98; 95%CI 1.17-3.35) and migration to Gulu for sex work (AOR=1.73; 95%CI 0.95-3.14) were positively correlated with inconsistent condom use by one-time clients. Correlates of inconsistent condom use by regular clients included: low sexual control by workers (AOR=4.63; 95%CI 2.32-9.23); physical/sexual violence by clients (AOR=3.48; 95%CI 1.85-6.53); police harassment (AOR=2.57; 95%CI 1.17-5.65); and being a single mother (AOR=2.07; 95%CI 1.09-3.93). Structural and interpersonal factors strongly influence inconsistent condom use by clients, with violence by clients and police, low sexual control by workers, migration and single-parenthood all linked to non-condom use. There is a need for peer-led structural interventions that improve access to occupational health and safety standards (e.g., violence prevention and alcohol/drug harm reduction policies/programming). Shifts away from the current punitive approaches towards SWs are integral to the success of such interventions, as they continue to undermine HIV prevention efforts.
机译：虽然性工作者（SWS）在乌干达的流行中携带普及，但仍然存在关于SWS之间预防艾滋病毒预防的结构驱动程序的实证研究。本研究审查了乌干达北部古鲁的一次性和常规客户的一次性和常规客户的不一致避孕套的驱动因素。从Gulu性健康研究中汲取数据，对年轻SWS的横断面研究，14岁及以上（2011-2012）。使用PEER / SW-LED OutReach招聘SWS，与艾滋病支持组织和其他CBO合作。多变量逻辑回归用于检查一次性和常规客户端的不一致避孕套使用的相关性。总共84.5％的381个SWS维修常客，每份393个SWS的76.8％，为一次性客户提供了不一致的客户避孕套使用。在多变量分析中，客户的身体/性暴力（AOR = 5.39; 95％CI 3.05-9.49），工人的性对低性控制（通过验证的脉冲量表测量）（AOR = 2.86; 95％CI 1.47-5.58），酒精/药物使用时使用（AOR = 1.98; 95％CI 1.17-3.35）和迁移到Gulu进行性工作（AOR = 1.73; 95％CI 0.95-3.14）与一次性客户的不一致安全套使用呈正相关。普通客户的不一致安全套使用包括：工人的低性控制（AOR = 4.63; 95％CI 2.32-9.23）;客户身体/性暴力（AOR = 3.48; 95％CI 1.85-6.53）;警察骚扰（AOR = 2.57; 95％CI 1.17-5.65）;作为单身母亲（AOR = 2.07; 95％CI 1.09-3.93）。结构和人际关系的影响力强烈影响客户的避孕套，受到客户和警察的暴力，工作人员的低性控制，迁移和单亲都与非避孕套使用有关。需要对等领导的结构干预，从而改善对职业健康和安全标准的获取（例如，暴力预防和酒精/药物损害政策/编程）。远离当前对SWS的惩罚方法转移是这种干预措施成功的一体化，因为它们继续破坏艾滋病毒预防努力。

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