Back to Annual Meeting

Back to Annual Meeting

Abstract #151213

• Slides (pdf) or Handout

Chi Chiao, PhD, Department of Public Health, National Cheng Kung University, No. 1, Ta-Hsueh Road, Tainan, 701, Taiwan, 886-6-2353535, chichiao@mail.ncku.edu.tw, Donald M. Morisky, ScD, MSPH, ScM, Community Health Sciences, UCLA School of Public Health, 11664 National Blvd, Los Angeles, CA 90064, Kate Ksobiech, PhD, Center for Urban Initiatives and Research, University of Wisconsin-Milwaukee, Engelmann Hall, Room B50, P.O. Box 413, Milwaukee, WI 53201-0413, and Robert Malow, PhD, AIDS Prevention Program, Florida International University, 3000 NE 151 Street, Miami, FL 33181.

BACKGROUND: Unprotected commercial intercourse is a primary vector in the escalating Southeast Asian HIV epidemic. This has led to an increased interest in promoting safer sex among sexual workers. This study examines the effects of a multilevel Social-Action Based Theory (SABT) intervention to enhance consistent condom use among Filipina commercial sex workers (FCSWs).

METHOD: Four sociodemographically similar Philippine cities were randomly assigned to have FCSWs within each city receive either an SABT intervention based on: 1) peer influence only; 2) FCSW's managers influence only; 3) combined peer/manager influence; or 4) a no intervention (control condition). The outcome variable, consistent condom use, was assessed by a validated six-item scale (Cronbach alpha = .78-.82). Regression analyses were conducted, which used the pooled baseline (N=866) and follow-up (N=808) samples, and which controlled for the clustering of multiple FCSWs at the same workplaces.

RESULTS: Only the combined peer/manager intervention condition produced significantly increased consistent condom users (p<0.05), after adjusting for socio-demographic, cognitive and other variables related to HIV prevention. Mediational analyses showed that the significant intervention effects for increasing consistent condom use were attributable to personal increased perceived HIV risks and emotional and instrumental support from workplaces. Increased consistent condom use was also positively associated with HIV testing (p<0.01).

DISCUSSION: These findings suggest that a successful sexual risk reduction intervention among FCSWs or similar disadvantaged populations must go beyond individual-based intervention strategies, and include others in the at-risk individual's social network.

Learning Objectives: Learning Objectives

At the end of the presentation the participants should be able
• To identify group differences in four conditions to promote safer sexual behaviors
• To describe and apply the analytical approaches used in this study
• To discuss HIV prevention strategies among disadvantaged populations that acknowledge the role of peer and manager influences

Keywords: Community-Based Health Promotion, Women and HIV/AIDS

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?


I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

• Slides (pdf) or Handout
Risk Behaviors and Prevention Strategies Targeting Commercial Sex Workers and Their Clients

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA