Explaining Condom use among Male Construction Worker Clients of Sex Workers in the Western Cape, South Africa

Background: Ten percent of sexually active men in sub-Saharan Africa report having had sex with a sex worker - a subpopulation facing a disproportionate burden of HIV and other sexually transmitted infections (STIs). In South Africa, an estimated 5% of new heterosexual HIV infections are attributable to female sex workers and 42% to their male clients. Despite this high vulnerability, empirical research on male clients of sex workers remains limited. Purpose: This study examined behavioral and cognitive determinants of self-reported condom use among male construction worker clients of sex workers in the Western Cape, South Africa. Methods: A cross-sectional survey was conducted among 227 male construction workers who reported sex with a female sex worker in the preceding three months. Participants were recruited across 18 construction sites operated by seven companies in the Western Cape. Three measures of self-reported condom use were analyzed: (1) condom use at last sex with a sex worker (retrospective),