A cross-sectional study to evaluate factors related to condom use with commercial sexual partners in workers from Ecuadorian companies.

BACKGROUND: Unprotected intercourse with sex workers is one of the major risk factors for HIV infection. Consistent condom use is a prerequisite to lower the incidence of HIV. METHODS: We assessed the prevalence of condom use and its determinants among company workers engaged with commercial sexual partners in Ecuador. The study was based on a random sample of 115 companies and 1,732 workers stratified by province and working sector and utilized the "Behavioral Surveillance Surveys - Adult questionnaire" developed by Family Health International. RESULTS: Of the 1,561 sexually active workers, 311 (19.9%) reported having intercourse with sex workers. Among them 25.9% did not use a condom at the last sexual intercourse. As for condom use frequency over the last 12 months, 29/208 (13.9%) reported never, 23 (11.1%) sometimes, 24 (11.5%) almost every time and 132 (63.5%) every time. Factors adversely affecting condom use frequency over the last 12 months were female gender (OR = 4.56, 95% CI: 1.45-14.4), older age (OR = 1.07, 95% CI: 1.03-1.10), low educational level (OR = 4.69, 95% CI: 1.95-11.3) and married workers living with spouse (OR = 7.66, 95 % CI: 3.08-19.1). By contrast, factors such as age at first sexual intercourse, job category, HIV transmission and prevention measure knowledge, single workers, previous exposure to HIV intervention programs and having a casual sexual partner were not affecting condom use frequency. When considering condom use during the last sexual intercourse or during the past 12 months with commercial sexual partners, results were similar. CONCLUSIONS: Workers with low education, older age, female gender and those married living with their spouse should be targeted for specific educational interventions.

A cross-sectional study to assess knowledge about HIV/AIDS transmission and prevention measures in company workers in Ecuador.

BACKGROUND: HIV/AIDS was first reported in Ecuador in 1984 and its prevalence has been increasing ever since. In 2009, the National AIDS Program reported 21,810 HIV/AIDS cases and confirmed that the worker population was amongst the most affected groups. The objective of this study was to assess knowledge about HIV transmission and prevention measures in company workers in Ecuador. METHODS: A cross-sectional survey based on a random sample of 115 companies (1,732 workers), stratified by three large provinces and working sectors (commerce, manufacturing and real estate) was conducted. A validated instrument developed by Family Health International was used to evaluate HIV prevention knowledge and common local misconceptions about HIV transmission. Descriptive statistics, chi square test and logistic regression analysis were performed using SAS. RESULTS: Incorrect knowledge about HIV/AIDS transmission were found in 49.1% (95% CI: 46.6-51.6) of subjects. Incorrect knowledge was higher among males (OR = 1.73 [1.39-2.15]), older subjects (OR = 1.35 [1.02-1.77]), subjects with lower education (OR = 3.72 [2.44-5.65]), manual labor workers (OR = 2.93 [1.82-4.73]) and subjects without previous exposure to HIV intervention programs (OR = 2.26 [1.79-2.86]). Incorrect knowledge about preventive measures was found among 32.9% (95%CI: 30.6-35.2) of respondents. This proportion was higher among subjects with lower education (OR = 2.28 [1.52-3.43]), married subjects (OR = 1.34 [1.07-1.68]), manual labor workers (OR = 1.80 [1.34-2.42]), and subjects not previously exposed to HIV intervention programs (OR = 1.44 [1.14-1.83]). CONCLUSIONS: HIV intervention programs targeting company workers are urgently needed to improve knowledge and reduce HIV transmission in Ecuador.