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In order to understand the social environmental forces faced by females involved in both injection drug use and sex work, and their associations with condom use during commercial sex, 200 participants were recruited using snowball sampling methods in Liuzhou, China. Of the participants, 41.0% used condoms consistently during commercial sex in the last 6 months. Adjusting for significant background variables, factors significantly associated with consistent condom use included: monthly income, soliciting venue, pattern of sex-work organization, experience of violence, social support, others' support of condom use, and utilization of HIV/STI-related services. In the final multivariate model, history of violence (OR = 0.39, 95% CI = 0.12-0.44), service utilization (OR = 2.18, 95% CI = 1.05-5.20), clients' willingness to use condoms (OR = 2.63, 95% CI = 1.06-6.54) and social support (OR = 0.39, 95% CI = 0.12-0.44) were significant. Service gaps for FSW-IDU exist, and expansion of social services and integration of psychosocial interventions are necessary.

Social Environmental Factors and Condom Use Among Female Injection Drug Users who are Sex Workers in China