Abstract:
Background: Consistent condom use remains a critical strategy in reducing HIV transmission, particularly among vulnerable populations such as Female Commercial Sex Workers (FCSWs). This study sought to examine the predictive validity of the Information-Motivation-Behavioral Skills (IMB) model in understanding condom-use behaviour among FCSWs at the Katosi landing site, Mukono, Uganda. Despite widespread knowledge about condoms, behavioural inconsistencies persist, necessitating evidence-based interventions.
Methods: A cross-sectional mixed-methods design was employed, involving 110 FCSWs aged 18–49 years, selected through convenience sampling. Quantitative data were collected from 80 participants using structured questionnaires measuring IMB model constructs and condom-use behaviour. Qualitative data were gathered from FGDs with participants. Descriptive statistics, Pearson’s correlation, and linear regression analyses were conducted using SPSS version 25, while thematic analysis was used for qualitative insights.
Results: Findings revealed that knowledge on condom use had a statistically significant positive correlation with past condom use (r = 0.256, p = 0.022), suggesting that FCSWs who were more informed about condom use were more likely to have used condoms in the past month. However, motivation (r = 0.174, p = 0.123) and behavioral skills (r = 0.137, p = 0.233) showed positive but non-significant relationships with condom use. Regression analysis showed that the IMB constructs collectively explained 8.0% of the variance in condom use (R² = 0.080, p = 0.103), with knowledge being the strongest individual predictor (β = 0.215, p = 0.081). A significant correlation was also found between knowledge and behavioral skills (r = 0.387, p < 0.001), indicating their interdependence.
Conclusion: The study concludes that among the IMB constructs, information (knowledge) plays a critical role in predicting condom-use behavior among FCSWs in this context. Although motivation and behavioral skills demonstrated non-significant statistical associations, their role in shaping decision-making and access behaviors remains contextually important. These findings affirm the partial applicability of the IMB model in the Ugandan sex work context.
Recommendations: The Ministry of Health should scale up behavioral skills training programs, including modules on condom negotiation and assertiveness. NGOs are advised to design peer-led, holistic interventions that integrate motivational and practical skill-building components. Health practitioners and peer educators should create safe dialogue spaces at landing sites, while policy makers should implement supportive legal and health policies.
