Predictors of female condom use among women exchanging street sex in New York City

Background: Alternative female-initiated barrier methods, such as the femal e condom, are needed among women exchanging street sex to enhance their abi lity to protect themselves from HIV and STD infection, Objective: To describe predictors of female condom use among 96 women excha nging sex for money and drugs on the streets of New York City. Study Design: A total of 113 sex workers received a baseline interview, a d emonstration on proper female condom use, and 10 female condoms. A total of 101 sex workers received a followed-up evaluation at 2 weeks, of which 96 were included in data analysis. Predictors of condom use were analyzed for (1) any type of use; and (2) use with commercial partners. Results: The strongest predictors of female condom use among this sample of sex workers were (1) living with someone with a drug or alcohol problem; ( 2) having heard of the female condom; and (3) homelessness. Current physica l or sexual abuse by a commercial partner and marriage decreased the probab ility of female condom use, Conclusions: Female condom distribution encouraged sex workers who may be m ost vulnerable or who reported characteristics or behaviors associated with the highest sexually transmitted disease and HIV risk to try female condom s with commercial partners. Implications for intervention development inclu de the need to develop innovative programs provided on the street (e.g., th rough peers) that can access homeless, drug-using sex workers in the most a t-risk environments.