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A Multilevel Analysis of the Impact of Socio-Structural and Environmental Influences on Condom Use Among Female Sex Workers

✍ Scribed by Alfonso Ang; Donald E. Morisky


Book ID
113060526
Publisher
Springer
Year
2011
Tongue
English
Weight
254 KB
Volume
16
Category
Article
ISSN
1090-7165

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✦ Synopsis


This study uses multilevel analysis to examine individual, organizational and community levels of influence on condom use among female commercial sex workers (FSW) in the Philippines. A randomized controlled study involving 1,382 female commercial sex workers assigned to three intervention groups consisting of peer education, managerial training, combined peer and managerial intervention and a usual care control group was conducted. The results of the multilevel analysis show that FSWs who work in establishments with condom use rules tend to have a higher level of condom use (Ξ²Β =Β .70, PΒ <Β 0.01). Among the different intervention groups, the combined peer and managerial intervention had the largest effect on condom use (Ξ²Β =Β 1.30, PΒ <Β 0.01) compared with the usual care group. Using a three-level hierarchical model, we found that 62% of the variation lies within individuals, whereas 24% and 14% of the variation lies between establishments, and communities, respectively. Standard errors were underestimated when clustering of the FSWs in the different establishments and communities were not taken into consideration. The results demonstrate the importance of using multilevel analysis for community-based HIV/AIDS intervention programs to examine individual, establishment and community effects.


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