Modeling Personal and Situational Influences on Condom Use Among Establishment-Based Commercial Sex Workers in the Philippines
Donald, E. Morisky; Judith, A. Stein; Carl, D. Sneed; Teodora, V. Tiglao; Kenn Liu; Roger Detels; Sandra, B. Temponko; Jane, C. Baltazar
Aids and Behavior 6(2): 163-172
2002
ISSN/ISBN: 1090-7165 DOI: 10.1023/a:1015401315918Document Number: 265025
This study assesses the impact of personal and situational influences on condom use among establishment-based commercial sex workers (CSWs) in the Philippines. Prior research employing bivariate and multivariate statistics for item-level analyses identified situational factors as more important than personal factors on condom use among the CSWs. In the current study, multilevel latent variable structural equation models analyzed at the establishment and individual levels examined the influences of constructs encompassing both personal and situational factors on condom use. The between-level analyses revealed significant direct relationships between managers' attitudes (both actual and as perceived by the CSWs) and Aids education and condom efficacy/use, confirming the presence of social, situational influences. The within-clusters analyses further revealed a predictive relationship between CSWs' perceptions of manager attitudes, personal condom attitudes, self-esteem, and condom efficacy/use. The discussion focuses on the relative influence of personal and situational factors on Csw condom use and the importance of addressing issues related to both factors in the development of effective interventions to promote safer sexual behavior among commercial sex workers.