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Randomized Controlled Trial
. 2012 May;16(4):934-42.
doi: 10.1007/s10461-011-9925-y.

A multilevel analysis of the impact of socio-structural and environmental influences on condom use among female sex workers

Alfonso Ang  1 , Donald E Morisky
Affiliations
Randomized Controlled Trial

A multilevel analysis of the impact of socio-structural and environmental influences on condom use among female sex workers

Alfonso Ang et al. AIDS Behav. 2012 May.

Abstract

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 (β = .70, P < 0.01). Among the different intervention groups, the combined peer and managerial intervention had the largest effect on condom use (β = 1.30, P < 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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Figures

Fig. 1
Fig. 1
Map of the Philippines showing the geographic location of the intervention sites (underlined cities)
See this image and copyright information in PMC

References

    1. Flicker S, Savan B, Kolenda B, Mildenberger M. A snapshot of community-based research in Canada: Who? What? Why? How? Health Educ Res. 2008;23(1):106–114. doi: 10.1093/her/cym007. - DOI - PubMed
    1. Minkler M. Community-based research partnerships: challenges and opportunities. J Urban Health. 2005;82(Suppl. 2):ii3–ii12. - PMC - PubMed
    1. Mosavel M, Simon C, van Stade D, Buchbinder M. Community-based participatory research (CBPR) in South Africa: engaging multiple constituents to shape the research question. Soc Sci Med. 2005;61:2577–2587. doi: 10.1016/j.socscimed.2005.04.041. - DOI - PMC - PubMed
    1. Higgins DL, Metzler M. Implementing community-based participatory research centers in diverse urban settings. J Urban Health. 2001;78:488–494. doi: 10.1093/jurban/78.3.488. - DOI - PMC - PubMed
    1. Msisha WM, Kapiga SH, Earls FJ, Subramanian SV. Place matters: multilevel investigation of HIV distribution in Tanzania. AIDS. 2008;22(6):741–748. doi: 10.1097/QAD.0b013e3282f3947f. - DOI - PMC - PubMed

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