Use of partial least squares path modelling to assess the willingness of Chinese female sex workers to participate in a microbicide trial

• We investigate willingness to participate (WTP) in a microbicide clinical trial of female sex workers (FSWs) in south-western China.
• We model WTP with possible motivations/barriers using exploratory factor analysis and partial least squares path modelling.
• Perceived benefits and hindrances have effects on WTP.
• FSWs were vulnerable and need more support for participating in a clinical trial.

ObjectivesTo investigate the willingness of Chinese female sex workers (FSWs) to participate (WTP) in a clinical trial of microbicides; to explore the potential hindrances and facilitating factors; and to provide support for future microbicide clinical trials by tailoring their design to better meet the specific needs of FSWs.Study designCross-sectional study.MethodsIn total, 404 FSWs were investigated using structured questionnaires. Exploratory factor analysis and partial least squares path modelling were used to explore the correlations between several influencing factors and WTP.ResultsThe WTP of FSWs enrolled in this study was high (53.47%, 216/404). Possible benefits from enrolment in the trial were positively associated with WTP, while concern about a hypothetical microbicide, potential physical harm, economic loss from participation, and fear of family or social isolation were negatively associated with WTP.ConclusionFSWs are appropriate participants in microbicide clinical trials, and are likely to benefit from effective microbicides. In a microbicide clinical trial, it is imperative to ensure protection of the rights, dignity, safety, confidentiality and welfare of FSW participants.