Abstract: ObjectiveTo investigate the impact of diverse factors on condom usage during the previous one month among older female sex workers (OFSWs) in Qingdao city and to provide evidences for making intervention measures and work centrality of disease control institutions.MethodsTotally 420 women aged ≥35 years,residing in Qingdao city at least 3 months,and having one or more commercial sex behaviors during the previous one month were recruited with respondent-driven sampling method and surveyed with a questionnaire from March to June 2014.ResultsThe proportion of consistent condom usage among the OFSWs in sex trade with clients during the previous one month were 33.3% (140/420) and 26.2% (140/420) of the OFSWs didn't use condom in the last sex trade.The explanatory contribution of sociodemographic characteristics,sex-work environment,and health or risk behavior factors to consistent condom usage of the OFSWS in sex trade during the previous one month were 10.2%,9.8%,and 6.0%,respectively.The results of hierarchical logistic regression showed that an educational level of junior high school was a protective factor for consistent condom usage of the OFSWs in sex trade during the previous one month;whereas,with monthly sex income of 5 000-9 999 or ≥10 000 RMB yuan,working in unconstant venues,all other peer OFSWs not using condoms consistently,having been exposed to violence during sex trade,and drug-use were risk factors.ConclusionDisease control institutions should focus on the OFSWs with high-income and drug-use and strengthen peer education among the OFSWs to promote consistent condom use for the prevention of AIDS and syphilis.