Characteristics of female sex workers who do not adhere to mandatory clinic visits for sexually transmitted infections

Background: In the Philippines, female sex workers (FSWs) are one potential source for STI/HIV transmission to the general population. Establishment-based (FSWs) in the Philippines are required to register at the local Social Hygiene Clinic to undergo weekly or bi-monthly STI examinations. However, many sex workers do not adhere to the mandatory policies. Objective: This study compares the characteristics of (FSWs) who adhered to SHC visits with those who did not (N=1330) during the 8-month study period. Methods: Data comes from a larger longitudinal study which assessed the efficacy of a behavioral intervention to reduce sexual risk among (FSWs) and their clients in the Philippines. Results: Compared to (FSWs) who were more likely to adhere to SHC visits during the study period, (FSWs) who did not have a clinic visit were more likely: employed in karaoke clubs as opposed to bars, beer gardens and nightclubs or other establishments (c²=200.98;p<.0001); single, never married, or living alone (c²=44.32;p<.0001); employed for approximately one-half the duration (months) as other sex workers (t=6.23; p<.0001); and employed at an establishment that did not have a condom-use policy (c²=52.26;p<.0001). Conclusion: Worksite condom-use policies have been suggested as a way to increase adherence to SHC visits as well as condom use because FSWs who keep their appointments receive counseling and skill communication from the clinic staff. Future interventions should encourage managers where employees negotiate sex to adopt condom-use policies. Specific targets are managers and employees of karaoke clubs, as well as more recently employed FSWs.