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Published in: BMC Infectious Diseases 1/2017

Open Access 01-12-2017 | Research article

Sex with sweethearts: Exploring factors associated with inconsistent condom use among unmarried female entertainment workers in Cambodia

Authors: Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Chanrith Ngin, Kolab Chhim, Carinne Brody

Published in: BMC Infectious Diseases | Issue 1/2017

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Abstract

Background

Despite the success in promoting condom use in commercial relationships, condom use with regular, noncommercial partners remains low among key populations in Cambodia. This study explores factors associated inconsistent condom use with sweethearts among unmarried sexually active female entertainment workers (FEWs).

Methods

In 2014, the probability proportional to size sampling method was used to randomly select 204 FEWs from entertainment venues in Phnom Penh and Siem Reap for face-to-face interviews. Multivariate logistic regression analysis was conducted to examine independent determinants of inconsistent condom use.

Results

Of total, 31.4% of the respondents reported consistent condom use with sweethearts in the past three months. After adjustment, respondents who reported inconsistent condom use with sweethearts remained significantly less likely to report having received any form of sexual and reproductive health education (AOR = 0.49, 95% CI = 0.22–0.99), but more likely to report having been tested for HIV in the past six months (AOR = 2.19, 95% CI = 1.03–4.65). They were significantly more likely to report having used higher amount of alcohol in the past three months (AOR = 1.29, 95% CI = 1.01–1.99) and currently using a contraceptive method other than condoms such as pills (AOR = 4.46, 95% CI = 1.34–10.52) or other methods (AOR = 9.75, 95% CI = 2.07–9.86).

Conclusions

The rate of consistent condom use in romantic relationships among unmarried FEWs in this study is considerably low. The importance of consistent condom use with regular, non-commercial partners should be emphasized in the education sessions and materials, particularly for FEWs who use non-barrier contraceptive methods.
Literature
1.
go back to reference International Labor Organization (ILO). Cambodia - addressing HIV vulnerabilities of indirect sex workers during the financial crisis: Situation analysis, strategies and entry points for HIV/AIDS workplace education. Bangkok: ILO; 2011. International Labor Organization (ILO). Cambodia - addressing HIV vulnerabilities of indirect sex workers during the financial crisis: Situation analysis, strategies and entry points for HIV/AIDS workplace education. Bangkok: ILO; 2011.
2.
go back to reference Ministry of Justice. Law on suppression of human trafficking and sexual exploitation 2008. Phnom Penh: Ministry of Justice; 2011. Ministry of Justice. Law on suppression of human trafficking and sexual exploitation 2008. Phnom Penh: Ministry of Justice; 2011.
3.
go back to reference Yi S, Tuot S, Yung K, Kim S, Chhea C, Saphonn V. Factors associated with risky sexual behavior among unmarried most-at-risk young people in Cambodia. Am J Public Health Res. 2014;2:211–20.CrossRef Yi S, Tuot S, Yung K, Kim S, Chhea C, Saphonn V. Factors associated with risky sexual behavior among unmarried most-at-risk young people in Cambodia. Am J Public Health Res. 2014;2:211–20.CrossRef
4.
go back to reference Ministry of Education, Youth and Sport (MoEYS). Examining Life Experiences and HIV Risks of Young Entertainment Workers in Four Cambodian Cities. Phnom Penh: MoEYS; 2012. Ministry of Education, Youth and Sport (MoEYS). Examining Life Experiences and HIV Risks of Young Entertainment Workers in Four Cambodian Cities. Phnom Penh: MoEYS; 2012.
5.
go back to reference Sopheab H, Tuot S, Chhea C, Gorbach P. Characteristics, risk behaviors and factors associated with abortion among female entertainment workers in Cambodia. Reprod Health. 2015;12:82.CrossRefPubMedPubMedCentral Sopheab H, Tuot S, Chhea C, Gorbach P. Characteristics, risk behaviors and factors associated with abortion among female entertainment workers in Cambodia. Reprod Health. 2015;12:82.CrossRefPubMedPubMedCentral
6.
go back to reference Chhea C, Saphonn V. Report on Estimation and Projections on HIV/AIDS in Cambodia 2010–2015. Phnom Penh: National Center for HIV/AIDS, Dermatology and STD; 2011. Chhea C, Saphonn V. Report on Estimation and Projections on HIV/AIDS in Cambodia 2010–2015. Phnom Penh: National Center for HIV/AIDS, Dermatology and STD; 2011.
7.
go back to reference National Center for HIV/AIDS, Dermatology and STD (NCHADS). Standard Operating Procedure (SOP) for Boosted Continuum of Prevention to Care and Treatment for Most at Risk Populations in Cambodia. Phnom Penh: Ministry of Health; 2013. National Center for HIV/AIDS, Dermatology and STD (NCHADS). Standard Operating Procedure (SOP) for Boosted Continuum of Prevention to Care and Treatment for Most at Risk Populations in Cambodia. Phnom Penh: Ministry of Health; 2013.
8.
go back to reference FHI 360 Cambodia. Program Review: Providing HIV/AIDS Prevention and Care for Entertainment Workers (Reporting Period: October 2008–June 2010). Phnom Penh: FHI 360 Cambodia; 2011. FHI 360 Cambodia. Program Review: Providing HIV/AIDS Prevention and Care for Entertainment Workers (Reporting Period: October 2008–June 2010). Phnom Penh: FHI 360 Cambodia; 2011.
9.
go back to reference Vun MC, Fujita M, Rathavy T, Eang MT, Sopheap S, Sovannarith S, et al. Achieving universal access and moving towards elimination of new HIV infections in Cambodia. J Int AIDS Soc. 2014;17:18905.CrossRefPubMedPubMedCentral Vun MC, Fujita M, Rathavy T, Eang MT, Sopheap S, Sovannarith S, et al. Achieving universal access and moving towards elimination of new HIV infections in Cambodia. J Int AIDS Soc. 2014;17:18905.CrossRefPubMedPubMedCentral
10.
go back to reference Couture MC, Sansothy N, Sapphon V, Phal S, Sichan K, Stein E, et al. Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine-type stimulant use: new challenges to HIV prevention and risk. Sex Transm Dis. 2011;38:33–9.CrossRefPubMedPubMedCentral Couture MC, Sansothy N, Sapphon V, Phal S, Sichan K, Stein E, et al. Young women engaged in sex work in Phnom Penh, Cambodia, have high incidence of HIV and sexually transmitted infections, and amphetamine-type stimulant use: new challenges to HIV prevention and risk. Sex Transm Dis. 2011;38:33–9.CrossRefPubMedPubMedCentral
11.
go back to reference Heng S, Tuot S. Mid-term review of the sustainable action against HIV and AIDS in communities (SAHACOM). Phnom Penh: KHANA; 2013. Heng S, Tuot S. Mid-term review of the sustainable action against HIV and AIDS in communities (SAHACOM). Phnom Penh: KHANA; 2013.
12.
go back to reference Yi S, Tuot S, Chhoun P, Brody C, Tith K, Oum S. The impact of a community-based HIV and sexual reproductive health program on sexual and healthcare-seeking behaviors of female entertainment workers in Cambodia. BMC Infect Dis. 2015;15:221.CrossRefPubMedPubMedCentral Yi S, Tuot S, Chhoun P, Brody C, Tith K, Oum S. The impact of a community-based HIV and sexual reproductive health program on sexual and healthcare-seeking behaviors of female entertainment workers in Cambodia. BMC Infect Dis. 2015;15:221.CrossRefPubMedPubMedCentral
13.
go back to reference Yi S, Tuot S, Chhoun P, Dyla PK, Tith K, Brody C. Factors associated with induced abortion among female entertainment workers: A cross-sectional study in Cambodia. BMJ Open. 2015;5:e007947.CrossRefPubMedPubMedCentral Yi S, Tuot S, Chhoun P, Dyla PK, Tith K, Brody C. Factors associated with induced abortion among female entertainment workers: A cross-sectional study in Cambodia. BMJ Open. 2015;5:e007947.CrossRefPubMedPubMedCentral
14.
go back to reference Zhao J, Song F, Ren S, Wang Y, Wang L, Liu W, et al. Predictors of condom use behaviors based on the Health Belief Model (HBM) among female sex workers: a cross-sectional study in Hubei Province. China PLoS One. 2012;7:e49542.CrossRefPubMed Zhao J, Song F, Ren S, Wang Y, Wang L, Liu W, et al. Predictors of condom use behaviors based on the Health Belief Model (HBM) among female sex workers: a cross-sectional study in Hubei Province. China PLoS One. 2012;7:e49542.CrossRefPubMed
15.
go back to reference Chen Y, Li X, Zhang C, Hong Y, Zhou Y, Liu W. Alcohol use and sexual risks: use of the Alcohol Use Disorders Identification Test (AUDIT) among female sex workers in China. Health Care Women Int. 2013;34:122–38.CrossRefPubMedPubMedCentral Chen Y, Li X, Zhang C, Hong Y, Zhou Y, Liu W. Alcohol use and sexual risks: use of the Alcohol Use Disorders Identification Test (AUDIT) among female sex workers in China. Health Care Women Int. 2013;34:122–38.CrossRefPubMedPubMedCentral
16.
go back to reference Bukenya J, Vandepitte J, Kwikiriza M, Weiss HA, Hayes R, Grosskurth H. Condom use among female sex workers in Uganda. AIDS Care. 2013;25:767–74.CrossRefPubMed Bukenya J, Vandepitte J, Kwikiriza M, Weiss HA, Hayes R, Grosskurth H. Condom use among female sex workers in Uganda. AIDS Care. 2013;25:767–74.CrossRefPubMed
17.
go back to reference Yam EA, Tinajeros F, Revollo R, Richmond K, Kerrigan DL, Garcia SG. Contraception and condom use among Bolivian female sex workers: relationship-specific associations between disease prevention and family planning behaviors. Health Care Women Int. 2013;34:249–62.CrossRefPubMed Yam EA, Tinajeros F, Revollo R, Richmond K, Kerrigan DL, Garcia SG. Contraception and condom use among Bolivian female sex workers: relationship-specific associations between disease prevention and family planning behaviors. Health Care Women Int. 2013;34:249–62.CrossRefPubMed
18.
go back to reference Gu J, Bai Y, Lau JT, Hao Y, Cheng Y, Zhou R, et al. Social environmental factors and condom use among female injection drug users who are sex workers in China. AIDS Behav. 2014;18:S181–91.CrossRefPubMed Gu J, Bai Y, Lau JT, Hao Y, Cheng Y, Zhou R, et al. Social environmental factors and condom use among female injection drug users who are sex workers in China. AIDS Behav. 2014;18:S181–91.CrossRefPubMed
19.
go back to reference Aho J, Koushik A, Rashed S. Reasons for inconsistent condom use among female sex workers: need for integrated reproductive and prevention services. World Health Popul. 2013;14:5–13.CrossRefPubMed Aho J, Koushik A, Rashed S. Reasons for inconsistent condom use among female sex workers: need for integrated reproductive and prevention services. World Health Popul. 2013;14:5–13.CrossRefPubMed
20.
go back to reference Deering KN, Bhattacharjee P, Bradley J, Moses SS, Shannon K, Shaw SY, et al. Condom use within non-commercial partnerships of female sex workers in southern India. BMC Public Health. 2011;11:S11.CrossRefPubMedPubMedCentral Deering KN, Bhattacharjee P, Bradley J, Moses SS, Shannon K, Shaw SY, et al. Condom use within non-commercial partnerships of female sex workers in southern India. BMC Public Health. 2011;11:S11.CrossRefPubMedPubMedCentral
21.
go back to reference National Institute of Public Health, National Institute of Statistics and ORC Macro. Cambodia Demographic and Health Survey 2010. Phnom Penh and Calverton: National Institute of Public Health, National Institute of Statistics, and ORC Macro; 2010. National Institute of Public Health, National Institute of Statistics and ORC Macro. Cambodia Demographic and Health Survey 2010. Phnom Penh and Calverton: National Institute of Public Health, National Institute of Statistics, and ORC Macro; 2010.
22.
go back to reference Yi S, Poudel KC, Yasuoka J, Ichikawa M, Tan V, Jimba M. Influencing factors for seeking HIV voluntary counseling and testing among tuberculosis patients in Cambodia. AIDS Care. 2009;21:529–34.CrossRefPubMed Yi S, Poudel KC, Yasuoka J, Ichikawa M, Tan V, Jimba M. Influencing factors for seeking HIV voluntary counseling and testing among tuberculosis patients in Cambodia. AIDS Care. 2009;21:529–34.CrossRefPubMed
23.
go back to reference Yi S, Poudel KC, Yasuoka J, Palmer PH, Yi S, Jimba M. Role of risk and protective factors in risky sexual behavior among high school students in Cambodia. BMC Public Health. 2010;10:477.CrossRefPubMedPubMedCentral Yi S, Poudel KC, Yasuoka J, Palmer PH, Yi S, Jimba M. Role of risk and protective factors in risky sexual behavior among high school students in Cambodia. BMC Public Health. 2010;10:477.CrossRefPubMedPubMedCentral
24.
go back to reference Yi S, Poudel KC, Yasuoka J, Palmer PH, Yi S, Jimba M. Risk vs. protective factors for substance use among adolescents in Cambodia. J Subst Use. 2011;16:14–26.CrossRef Yi S, Poudel KC, Yasuoka J, Palmer PH, Yi S, Jimba M. Risk vs. protective factors for substance use among adolescents in Cambodia. J Subst Use. 2011;16:14–26.CrossRef
25.
go back to reference Goldberg DP. The detection of psychiatric illness by questionnaire: A technique for identification and assessment of non-psychotic psychiatric illness. London: Oxford University Press; 1972. Goldberg DP. The detection of psychiatric illness by questionnaire: A technique for identification and assessment of non-psychotic psychiatric illness. London: Oxford University Press; 1972.
26.
go back to reference Goldberg DP, Williams P. A user’s guide to the General Health Questionnaire. Winsor: NFER-Nelson; 1988. Goldberg DP, Williams P. A user’s guide to the General Health Questionnaire. Winsor: NFER-Nelson; 1988.
27.
go back to reference Goldberg DP, Oldehinkel T, Ormel J. Why GHQ threshold varies from one place to another. Psychol Med. 1998;28:915–21.CrossRefPubMed Goldberg DP, Oldehinkel T, Ormel J. Why GHQ threshold varies from one place to another. Psychol Med. 1998;28:915–21.CrossRefPubMed
29.
go back to reference Family Health International (FHI). Behavioral Surveillance Surveys (BSS), Guidelines for repeated behavioral surveys in populations at risk of HIV: Chapter 5: Weighting in multi-stage sampling. Washington: FHI; 2000. Family Health International (FHI). Behavioral Surveillance Surveys (BSS), Guidelines for repeated behavioral surveys in populations at risk of HIV: Chapter 5: Weighting in multi-stage sampling. Washington: FHI; 2000.
30.
go back to reference Chow EP, Muessig KE, Yuan L, Wang Y, Zhang X, Zhao R, et al. Risk behaviours among female sex workers in China: a systematic review and data synthesis. PLoS One. 2015;10:e0120595.CrossRefPubMedPubMedCentral Chow EP, Muessig KE, Yuan L, Wang Y, Zhang X, Zhao R, et al. Risk behaviours among female sex workers in China: a systematic review and data synthesis. PLoS One. 2015;10:e0120595.CrossRefPubMedPubMedCentral
31.
go back to reference Luchters S, Richter ML, Bosire W, Nelson G, Kingola N, Zhang XD, et al. The contribution of emotional partners to sexual risk taking and violence among female sex workers in Mombasa, Kenya: a cohort study. PLoS One. 2013;8:e68855.CrossRefPubMedPubMedCentral Luchters S, Richter ML, Bosire W, Nelson G, Kingola N, Zhang XD, et al. The contribution of emotional partners to sexual risk taking and violence among female sex workers in Mombasa, Kenya: a cohort study. PLoS One. 2013;8:e68855.CrossRefPubMedPubMedCentral
32.
go back to reference Yi S, Chhoun P, Brant S, Kita K, Tuot S. The Sustainable Action against HIV and AIDS in Communities (SAHACOM): End-of-project evaluation. Phnom Penh: KHANA; 2014. Yi S, Chhoun P, Brant S, Kita K, Tuot S. The Sustainable Action against HIV and AIDS in Communities (SAHACOM): End-of-project evaluation. Phnom Penh: KHANA; 2014.
33.
go back to reference Rogers RW, Prentice-Dunn S, Gochman DS. Handbook of health behavior research: Personal and social determinants. New York: Plenum Press; 1997. Rogers RW, Prentice-Dunn S, Gochman DS. Handbook of health behavior research: Personal and social determinants. New York: Plenum Press; 1997.
34.
go back to reference Rosenstock IM, Stretcher VJ, Becker MH. The health belief model and HIV risk behavior change. In: Preventing AIDS: theories and methods of behavioral interventions. New York: Plenum Press; 1994. Rosenstock IM, Stretcher VJ, Becker MH. The health belief model and HIV risk behavior change. In: Preventing AIDS: theories and methods of behavioral interventions. New York: Plenum Press; 1994.
35.
go back to reference Brody C, Tuot S, Chhoun P, Pal K, Chhim K, Yi S. Recent HIV Testing and Associated Risk Factors among Female Entertainment Workers in Cambodia. Int J STD & AIDS. (In press). Brody C, Tuot S, Chhoun P, Pal K, Chhim K, Yi S. Recent HIV Testing and Associated Risk Factors among Female Entertainment Workers in Cambodia. Int J STD & AIDS. (In press).
36.
go back to reference Yam EA, Mnisi Z, Mabuza X, Kennedy C, Kerrigan D, Tsui A, et al. Use of dual protection among female sex workers in Swaziland. Int Perspect Sex Reprod Health. 2013;39:69–78.CrossRefPubMed Yam EA, Mnisi Z, Mabuza X, Kennedy C, Kerrigan D, Tsui A, et al. Use of dual protection among female sex workers in Swaziland. Int Perspect Sex Reprod Health. 2013;39:69–78.CrossRefPubMed
37.
go back to reference Cates Jr W, Steiner MJ. Dual protection against unintended pregnancy and sexually transmitted infections: what is the best contraceptive approach? Sex Transm Dis. 2002;29:168–74.CrossRefPubMed Cates Jr W, Steiner MJ. Dual protection against unintended pregnancy and sexually transmitted infections: what is the best contraceptive approach? Sex Transm Dis. 2002;29:168–74.CrossRefPubMed
38.
go back to reference UNFPA Asia Pacific Regional Office. Socio-Cultural Influences on the reproductive health of migrant women: A review of literature in Cambodia, Lao PDR, Thailand and Viet Nam. New York: UNFPA; 2011. UNFPA Asia Pacific Regional Office. Socio-Cultural Influences on the reproductive health of migrant women: A review of literature in Cambodia, Lao PDR, Thailand and Viet Nam. New York: UNFPA; 2011.
Metadata
Title
Sex with sweethearts: Exploring factors associated with inconsistent condom use among unmarried female entertainment workers in Cambodia
Authors
Siyan Yi
Sovannary Tuot
Pheak Chhoun
Khuondyla Pal
Chanrith Ngin
Kolab Chhim
Carinne Brody
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-016-2101-2

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