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RESEARCH ARTICLE

Depressive symptoms and condom use with clients among female sex workers in China

Yan Hong A D , Xiaoming Li A , Xiaoyi Fang B and Ran Zhao C
+ Author Affiliations
- Author Affiliations

A Prevention Research Center, Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201-2196, USA.

B Institute of Developmental Psychology, Beijing Normal University, Beijing, China.

C Department of Applied Psychology, Central University of Finance and Economics, Beijing, China.

D Corresponding author. Email: yanhong2007@gmail.com

Sexual Health 4(2) 99-104 https://doi.org/10.1071/SH06063
Submitted: 3 November 2006  Accepted: 24 February 2007   Published: 23 May 2007

Abstract

This study examines the association between depressive symptoms and condom use with clients among 278 female sex workers (FSW) in Guangxi, China. About 62% of these FSW had a high level of depressive symptoms (CES-D total score ≥16). Multiple logistic regression analyses indicated that FSW with high level of depressive symptoms were less likely to use condoms consistently (aOR = 0.50, 95% CI: 0.28–0.89) or use condoms properly (aOR = 0.44, 95% CI: 0.20–0.99). The findings suggested that HIV prevention programs targeted at FSW should take into consideration the level of depression they experience.

Additional keywords: HIV prevention programs, rural county.


Acknowledgements

This project was supported by a grant from the NIH Office of AIDS Research (R01MH064878–3S1). The authors wish to thank the other research team members from the China CDC National Center for AIDS Control and Prevention, Guangxi Zhuang Autonomous Region CDC, H County Anti-Epidemic Station. The authors also wish to thank Joanna Zwemer for assistance in preparing the manuscript.


References


[1] Orr ST,  Celentano DD,  Santelli J,  Burwell L. Depressive symptoms and risk factors for HIV acquisition among black women attending urban health centers in Baltimore. AIDS Educ Prev 1994; 6 230–6.
PubMed |

[2] DiClemente RJ,  Wingood GM,  Crosby RA,  Sionean C,  Brown LK,  Rothbaum B, et al. A prospective study of psychological distress and sexual risk behavior among black adolescent females. Pediatrics 2001; 108 E85.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[3] Shrier LA,  Harris SK,  Sternberg M,  Beardslee WR. Associations of depression, self-esteem, and substance use with sexual risk among adolescents. Prev Med 2001; 33 179–89.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[4] Stiffman AR,  Dore P,  Earls F,  Cunningham R. The influence of mental health problems on AIDS-related risk behaviors in young adults. J Nerv Ment Dis 1992; 180 314–20.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[5] Grella CE,  Anglin D,  Annon JJ. HIV risk behaviors among women in methadone maintenance treatment. Subst Use Misuse 1996; 31 277–301.
PubMed |

[6] Williams CT,  Latkin CA. The role of depressive symptoms in predicting sex with multiple and high-risk partners. J Acquir Immune Defic Syndr 2005; 38 69–73.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[7] de Vroome EMM,  de Wit JBF,  Stroebe W,  Sandfort TGM,  van Griensven GJP.. Sexual behavior and depression among HIV-positive gay men. AIDS Behav 1998; 2 137–49.
Crossref | GoogleScholarGoogle Scholar |

[8] Hutton HE,  Lyketsos CG,  Zenilman JM,  Thompson RE,  Erbelding EJ. Depression and HIV risk behaviors among patients in a sexually transmitted disease clinic. Am J Psychiatry 2004; 161 912–4.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[9] Crepaz N,  Marks G. Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Health Psychol 2001; 20 291–9.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[10] Kalichman SC,  Weinhardt L. Negative affect and sexual risk behavior: comment on Crepaz and Marks (2001). Health Psychol 2001; 20 300–1.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[11] Alegria M,  Vera M,  Freeman DH,  Robles R,  Santos MC,  Rivera CL. HIV infection, risk behaviors, and depressive symptoms among Puerto Rican sex workers. Am J Public Health 1994; 84 2000–2.
PubMed |

[12] Yang H,  Li X,  Stanton B,  Liu H,  Liu H,  Wang N, et al. Heterosexual transmission of HIV in China: a systematic review of behavioral studies in the past two decades. Sex Transm Dis 2005; 32 270–80.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[13] Cohen MS . HIV and STD: highlights of data on epidemiology, prevention strategies, and China’s growing challenge with AIDS. Paper presented at: International Society for Sexually Transmitted Disease Research; 2003 July 27–30; Ottawa, Canada.

[14] Huang Y,  Henderson GE,  Pan S,  Cohen MS. HIV/AIDS risk among brothel-based female sex workers in China: assessing the terms, content, and knowledge of sex work. Sex Transm Dis 2004; 31 695–700.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[15] Gil VE,  Wang MS,  Anderson AF,  Lin GM,  Wu ZO. Prostitutes, prostitution and STD/HIV transmission in mainland China. Soc Sci Med 1996; 42 141–52.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[16] World Health Organization (WHO). Sex work in Asia. WHO: Geneva; 2001. Available online at: http://www.wpro.who.int/themes_focuses/theme1/focus4/pub_doc.asp [verified 5 September 2005]

[17] Li X,  Wang B,  Fang X,  Zhao R,  Stanton B,  Hong Y, et al. Short-term effect of a cultural adaptation of voluntary counseling and testing among female sex workers in China: a quasi-experimental trial. AIDS Educ Prev 2006; 18 406–19.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[18] Carlson RG,  Wang J,  Siegal HA,  Falck RS,  Guo J. An ethnographic approach to targeted sampling: Problems and solutions in AIDS prevention research among injection drug and crack-cocaine users. Hum Organ 1994; 53 279–86.


[19] Radloff LS. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1 385–401.
Crossref | GoogleScholarGoogle Scholar |

[20] Cheung CK,  Bagley C. Validating an American scale in Hong Kong: the Center for Epidemiological Studies Depression Scale (CES-D). J Psychol 1998; 132 169–86.
PubMed |

[21] Lin N. Measuring depressive symptomatology in China. J Nerv Ment Dis 1989; 177 121–31.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[22] Comstock GW,  Helsing KJ. Symptoms of depression in two communities. Psychol Med 1976; 6 551–63.
PubMed |

[23] Roberts RE,  Vernon SW. The Center for Epidemiologic Studies Depression Scale: its use in a community sample. Am J Psychiatry 1983; 140 41–6.
PubMed |

[24] Sterk CE,  Theall KP,  Elifson KW. The impact of emotional distress on HIV risk reduction among women. Subst Use Misuse 2006; 41 157–73.
Crossref | GoogleScholarGoogle Scholar | PubMed |