Condom Use Among Male Sex Workers With Their Male Clients in Mombasa, Kenya: Results of a Sub-analysis of a Pilot, Multilevel, Structural, HIV Risk-Reduction Intervention.

The analysis is cross-sectional baseline data, so it cannot show that higher self-efficacy or knowledge caused condom use, or that the intervention changed behaviour. Condom use, eligibility, STI history and HIV status were self-reported, so the analysis cannot verify those reports. The study did not estimate possible cluster effects from recruiting participants at the same venues, so confidence intervals for associations may be too narrow. The power calculation was designed for longitudinal change, not this cross-sectional analysis, so the sample may not be sized to detect these associations. The knowledge and self-efficacy scales were used with Kenyan male sex workers for the first time, so their exact meaning in this group is uncertain. Participants came only from bars/clubs, so findings may not apply to male sex workers who work from homes, streets or the internet. This was a sub-analysis of a pilot intervention, not a test of the intervention's effectiveness.

The authors reported no real or perceived vested interests related to this article. The supplied publication types indicate NIH extramural support, but the article text does not state whether the funder designed or wrote the study.

Do not read the associations as proof that self-efficacy counselling increases condom use. This was a baseline cross-sectional survey of self-reported behaviour, and it did not test the intervention's effect.