Long-term effects of condom promotion programmes for vaginal and oral sex on sexually transmitted infections among sex workers in Singapore

AIDS. 2004 May 21;18(8):1195-9. doi: 10.1097/00002030-200405210-00013.


Objectives: To evaluate the long-term impact of condom promotion programmes for vaginal and oral sex among female brothel-based sex workers in Singapore.

Design: A pre-test/post-test comparison group followed by a time series design was used to compare trends in condom use for vaginal sex and cervical gonorrhoea incidence from 1990 to 2002 across cross-sectional samples of sex workers before and after programme implementation in 1995. The subsequent condom promotion programme for oral sex was evaluated using the interrupted time series with a retrospective pre-test to post-test matched control group design.

Methods: Sex workers completed a questionnaire before and 6 months after participation in educational sessions. Cervical and pharyngeal swabs were taken monthly for cultures for Neisseria gonorrhoeae.

Results: Consistent condom use for vaginal sex increased significantly from < 45.0% before 1995 (pre-intervention period) to 95.1% in 2002, with a corresponding decline in cervical gonorrhoea incidence from > 30 to 2/1000 person-months. Adjustment for temporal changes in sociodemographic characteristics did not materially alter the trends. Consistent oral condom use increased significantly from < 50% before 1996 to 97.2% in 2002, with a corresponding decline in pharyngeal gonorrhoea from > 12 to 4.7/1000 person-months.

Conclusion: The interventions produced sustained high levels of condom use for vaginal and oral sex with corresponding declines in cervical and pharyngeal gonorrhoea incidence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Condoms / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • Gonorrhea / epidemiology
  • Gonorrhea / prevention & control*
  • Health Promotion / methods
  • Humans
  • Incidence
  • Pharyngeal Diseases / epidemiology
  • Pharyngeal Diseases / prevention & control*
  • Retrospective Studies
  • Safe Sex / statistics & numerical data*
  • Sex Work / statistics & numerical data*
  • Singapore / epidemiology
  • Uterine Cervical Diseases / epidemiology
  • Uterine Cervical Diseases / prevention & control*