Correlates of Self-Efficacy for Condom Use among Male Clients of Female Sex Workers in Tijuana, Mexico

Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. 

Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past four months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. 

A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. 

Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior.

Read more at: http://ht.ly/S783S 

By: Tyson Volkmann,1 Karla D. Wagner,2 Steffanie A. Strathdee,2 Shirley J. Semple,3 Danielle C. Ompad,4 Claudia V. Chavarin,3 and Thomas L. Patterson3

²Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA

³Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680, USA

⁴

²Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA

³Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680, USA

⁴

1Joint Doctoral Program in Public Health, San Diego State University and University of California, San Diego, San Diego, CA, USA
2Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
3Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680, USA
4Department of Nutrition, Food Studies, and Public Health and Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA

1Joint Doctoral Program in Public Health, San Diego State University and University of California, San Diego, San Diego, CA, USA

1Joint Doctoral Program in Public Health, San Diego State University and University of California, San Diego, San Diego, CA, USA