A Pragmatic Intervention to Promote Condom Use by Female Sex Workers in Thailand

Bull World Health Organ. 1999;77(11):888-94.

Abstract

An overview is presented of a multifaceted intervention to promote consistent condom use by female commercial sex workers in Thailand, in the context of the government's 100% condom use policy for preventing spread of human immunodeficiency virus (HIV) infection. The project is described with reference to a succession of stages including pre-programme needs assessment, intervention design, implementation and evaluation. The key elements of the intervention were video scenarios and discussions coordinated by health personnel, and video-depicted open-ended narratives aimed at helping sex workers to explore their personal and work-related dilemmas and concerns. A core objective was to enhance sex workers' self-esteem and perceived future with a view to strengthening their motivation to take preventive action against HIV infection. The intervention was evaluated using a combination of qualitative (process evaluation) and quantitative (outcome) methods. The outcome evaluation was undertaken using a pretest, post-test intervention and control group quasi-experimental design. There were significant increases in consistent condom use among the intervention groups but not among the controls. Pragmatic stability is advocated for the Thai sex industry and recommendations are offered for good quality HIV prevention activities.

PIP: This paper presents an overview of a multifaceted intervention project to promote consistent condom use by female commercial sex workers in Thailand. This project is in context of the government's 100% condom use policy for preventing the spread of HIV. It involves a succession of stages including preprogram needs assessment, intervention design, project implementation and evaluation. A total of 222 cases involving equal proportions of high-income and low-income commercial sex workers were classified into intervention and control groups and completed the pre-test and post-test surveys. The intervention consisted mainly of video scenarios and discussions coordinated by health personnel and of video-depicted open-ended narratives. These methods were aimed at helping sex workers' self-esteem and perceived future with a view to strengthening their motivation to take preventive action against HIV infection. Using a combination of qualitative and quantitative methods in the evaluation process, significant increases in consistent condom use were noted among the intervention groups but not among the control groups.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Condoms*
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control
  • Health Knowledge, Attitudes, Practice
  • Health Promotion / organization & administration*
  • Humans
  • Needs Assessment / organization & administration
  • Outcome and Process Assessment, Health Care / organization & administration
  • Program Development
  • Program Evaluation
  • Self Efficacy
  • Sex Education / organization & administration*
  • Sex Work* / psychology
  • Sex Work* / statistics & numerical data
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / prevention & control
  • Thailand / epidemiology
  • Women's Health