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Health Education Research, Vol. 11, No. 4, 423-432, 1996
© 1996 Oxford University Press

other

Controlled evaluation of a behavioural intervention programme on condom use and gonorrhoea incidence among sex workers in Singapore

M.L. Wong, Roy Chan1, James Lee2, David Koh1 and Christina Wong

Department of Community, Occupational and Family Medicine, National University of Singapore Singapore 0511
1Department of STD Control, National Skin Centre Singapore 1130
2Epidemiology Program, Cancer Research Center of Hawail, University of Hawail 1236 Lauhala Street, Honolulu, HI 96813, USA

We evaluated the impact of a behavioural intervention programme on condom use and gonorrhoea incidence among female brothel-based sex workers in Singapore. All 128 sex workers from one locality were assigned to an intervention group and 125 sex workers from another relatively comparable locality served as controls. The intervention programme concentrated on developing sex workers' condom negotiation skills, and on gathering support from peers, brothel keepers and health staff in promoting condom use. The three outcome measures are self-reported success in persuading clients to use condoms, refusal of sex without a condom, and cumulative gonorrhoea incidence as measured by the percentage of sex workers with a new occurrence of a positive culture in the 5 month period before and after the intervention. The intervention group showed a statistically greater improvement in negotiation skills as compared to the controls. Sex workers exposed to the intervention were almost twice as likely than controls to always refuse unprotected sex (adjusted rate ratio of 1.90, 95% CI: 1.22–2.94). Cumulative gonorrhoea incidence declined considerably (77.1%) in the intervention group but only moderately (37.6%) in the control group.


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