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Contextual Determinants of Condom Use Among Female Sex Exchangers in East Harlem, NYC: An Event Analysis

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Abstract

Recent studies have revealed a variety of contexts involving HIV risk behaviors among women who exchange sex for money or drugs. Event analysis was used to identify the individual, relationship, and contextual factors that contribute to these high-risk sex exchange practices. Analyses were conducted on data obtained from 155 drug-using women who reported details of their most recent sex exchange event with male clients. The majority of sex exchange encounters (78%) involved consistent condom use. In multivariable analysis, protective behavior was associated primarily with situational and relationship variables, such as exchange location, substance use, sexual practices, and respondent/client discussion and control. In order to inform HIV prevention programs targeted to women sex exchangers, further research is needed on the contextual determinants of risk, especially with regard to condom-use negotiation and factors involving substance use that adversely affect women's ability to manage protective behavior in the context of sex exchange.

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Acknowledgements

This research was funded by NIDA grant # R01 DA10864 (S. Tortu, P.I.). Data from an earlier version of this study were presented at the AIDS Impact Conference, Ottawa, July 1999. The authors thank our capable project staff: Sherelle Bonaparte, Hanifah Burns, Jeanne Campbell, Audrey Grandy-Lampkin, Christine Ramos, Leilani Torres, and Leonora Wengraf. Jeanine Botta provided technical assistance. We especially thank the women of East Harlem who participated in this study.

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Authors and Affiliations

  1. National Development and Research Institutes, 71 West 23rd Street, 8th Floor, New York, 10010, New York, USA

    James M. McMahon, Enrique R. Pouget, Rahul Hamid & Alan Neaigus

  2. School of Public Health, Louisiana State University, New Orleans, Louisiana, USA

    Stephanie Tortu

  3. School of Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA

    Enrique R. Pouget

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  1. James M. McMahon
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  2. Stephanie Tortu
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  3. Enrique R. Pouget
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Correspondence to James M. McMahon.

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McMahon, J.M., Tortu, S., Pouget, E.R. et al. Contextual Determinants of Condom Use Among Female Sex Exchangers in East Harlem, NYC: An Event Analysis. AIDS Behav 10, 731–741 (2006). https://doi.org/10.1007/s10461-006-9093-7

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