影响青岛市大龄女性性工作者安全套使用的心理社会因素分析

An investigation on the psychosocial factors affecting condom use among older sex workers in Qingdao City

目的探讨影响大龄女性性工作者(OFSWs)安全套使用的心理社会因素,为相关部门制定针对性干预措施提供理论依据。方法采用同伴驱动抽样法,于2014年3~6月在青岛市招募420名OFSWs并进行问卷调查。应用多元线性回归和路径分析探究影响OFSWs安全套使用的心理社会因素及效应大小。结果多元线性回归显示,OFSWs安全套使用行为的保护因素为安全套使用意图(b_1=0.38)和自我效能(b_1=0.77),危险因素为工作环境(b_1=-0.12)。路径分析发现,疾病易感性感知(β_2=-0.12)、负向预期(β_2=-0.22)对OFSWs安全套使用行为有间接负向效应;自我效能(β_2=0.56)、同伴使用感知(β_2=0.13)对OFSWs安全套使用行为有间接正向效应;自我效能(β_2=0.66)和安全套使用意图(β_2=0.14)对OFSWs安全套使用行为有直接正向效应。结论自我效能对青岛市OFSWs安全套使用的影响最大,提示干预重点应为提高OFSWs使用和劝说客人使用安全套的信心。

Objective To explore the psychosocial factors affecting condom use among older female sex workers（OFSWs） in Qingdao City and to provide information for departments and agencies involved to take intervention measures. Methods Totally 420 OFSWs were recruited with respondent-driven sampling method and surveyed with questionnaire during March and June 2014. Multiple linear regression and path analysis were used to analyze the psychosocial factors influencing condom use and the effects. Results Multiple linear regression showed that condom use intention（b1=0.38） and self-efficacy（b1=0.77） were the protective factors of condom use behavior, while the work environment（b1 =-0.12） was the risk factor. Path analysis found that perception of disease susceptibility（β2=-0.12） and negative expectation（β2=-0.22） had indirect negative effects on condom use behavior; self-efficacy（β2 = 0.56） and perception of companion use（β2 = 0.13） had indirect positive effects; self-efficacy（β2 = 0.66） and condom use intention（β2=0.14） had direct positive effects. Conclusion Self-efficacy has the greatest impact on condom use among OFSWs in Qingdao City and disease control departments should improve OFSWs＇ confidence in using condoms and persuading guests to use condoms.