The authors declare to have no competing interests.
MC carried out the design, implementation, and acquisition of data in the study and drafted the manuscript. MF has been involved in revising it critically for important intellectual content. AA participated in the design of the study, has been involved in revising it critically for important intellectual content and supervised the statistical analysis. TB has been involved in the implementation of the study and revising it critically for important intellectual content. ND performed the statistical analyses and contributed to data interpretation. DB has been involved in the implementation of the study and revising it critically for important intellectual content. All authors read and approved the final manuscript.
Maria de Carmen Cabezas, MD, PhD., researcher at the School of Medicine of Pontifical Catholic University, Quito, Ecuador; her expertise is in HIV prevention programs.
Marco Fornasini, MD, PhD in epidemiology is a full time professor and researcher at Universidad de las Americas, Quito, Ecuador; his expertise is in chronic diseases and infectious diseases.
Nadia Dardenne, MSc, is a biostatistician at the School of Public Health, University of Liège, Liège, Belgium.
David Barmettler, MSc in Public Health, is coordinator in Accreditation Canada Ecuador.
Teresa Borja, PhD in Psychology is a full time professor and researcher at the Universidad San Francisco de Quito, Ecuador; her expertise is in sexology and HIV.
Adelin Albert, PhD, is professor emeritus of medical informatics and biostatistics, School of Public Health, University of Liège, Liège, Belgium.
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.
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.
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.
Workers with low education, older age, female gender and those married living with their spouse should be targeted for specific educational interventions.