[Gender and its impact on condom use among HIV male serodiscordant couples]

To study the gender-based factors which influence the condom use among the HIV serodiscordant couples in selected regions of China.

Based on the analysis of the existing case reporting database and convenient sampling in the cross-sectional study, a total of 481 female HIV-negative spouses completed an interviewer-administered questionnaire regarding demographic characters, the knowledge, behaviors and the gender-based factors in five sites of four provinces Sichuan (Zhaojue), Yunnan (Dali), Henan (Weishi) and Guangxi (Lingshan and Luzhai), during June-September 2011. χ(2) analysis and logistic regression were used to study the gender-based factors influencing condom use among the participants.

Among the 481 female HIV-negative spouses, the average age was (35.1 ± 6.7) years, and the proportion of Han and Yi nationality were high, 43.5% (209/481) and 41.8% (201/481), respectively. The awareness of knowledge related to HIV spousal transmission was high (≥ 79.6%). A total of 86.9% (418/481) used condom more frequently after informed the status of HIV infection of their spouses, and the condom use consistency was 56.6% (272/481). A total of 57.6% (277/481) reported low sexual relationship power; 34.5% (166/481) experienced forced sex in the past 1 year. And the proportion of condom use self-efficacy from 0 to 3 scores were 12.7% (61/481), 23.9% (115/481), 8.7% (42/481) and 54.7% (263/481), respectively (median = 3). Han and other nationality were significantly more likely to use condom consistently than Yi, with odds ratio (95%CI) of 0.01 (0.00 - 0.03) and 0.01 (0.00 - 0.04), and the female spouses with higher condom use self-efficacy used condom more consistently than the lower ones, with odds ratio (95%CI) of 0.20(0.11 - 0.34).

The female spouses with higher condom use self-efficacy were more likely to use condom consistently after excluding the confounding effect of nationality.