Evaluation Of Intervention Effectiveness Among Street-based Female Sex Workers In Chongqing

Aim: To know the status of HIV relative knowledge, attitude, behaviour and needs among street-based female sex workers(FSWs) in main district of Chongqing, carry out directional comprehensive intervention study, evaluate the effectiveness, investigate intervention problem and find resolvent, provide basic information to relevant department for formulating HIV prevention and control strategy.Method: quantitative and qualitative study methods are both used in this research.1. Qualitative interview: Different guidelines were used among different interviewers. Focus group discussion (FGD) were conducted among selected common FSWs; in-depth interviews were done among FSWs, healthcare providers and related leaders respectively. 46 persons were interviewed and thematic Framework method was applied to analyze qualitative data from both FGD and in-depth interviews.2. Quantitative study: Two sties, with similar socioeconomic development and geographical conditions in Yuzhong district were selected by random-cluster sampling; questionnaire surveys were conducted among FSWs of the two selected places. There were 100 and 112 questionnaire pre-and post-intervention, respectively, the data were doubled entered into database of EPDATA software. In quantitative data analysis, SPSS15.0 software was applied.Result:1. Qualitative resultChange of knowledge: awareness rate of knowledge about HIV increased, most of FSWs can exactly answer the transmission and prevention knowledge, but a few misunderstand the non-transmission route.Change of attitude: after intervention, FSWs can correctly know AIDS, turned fear and keep far away to be willing to communicate and concern AIDS-infected patient.Change of behavior: after intervention, FSWs begin to protect themselves, take protective measure, condom use rate increased, and actively to buy condom.Change of accessibility: after intervention, majority know HIV voluntary consultant and test(VCT), some quit face to face VCT for sensitiveness, but did it by telephone, however, active detection rate is not high.Effectiveness of peer education (PE): PE played critic role in the intervention, helps FSWs to communicate, and concern each other. Form is explaining, distribute propaganda and free condom.Needs of FSWs: content with symptom of HIV, drugs, prognosis, and relevant policy; form with face to face explain of professionals firstly, then television, thirdly with peer education.Survival status: FSWs is with low socio-economic status, bad living condition, fluidity, no job, they mainly concern how to earn money, worried to have gynecologic disease, when sick they firstly choose buy some drug themselves, secondly go to private clinic, FSWs have narrow communication net, few close friends, the clients are mostly in the bottom of the society, sex environment is serious and with low price.2. quantitative resultAwareness of knowledge: awareness rate of HIV knowledge increased remarkably, form 28% to 70.5%, especially three transmission routes of HIV, but non-transmission route changed not so much.Access to obtained knowledge: 39% of FSWs showed no way to got AIDS knowledge pre-intervention, they began to learn more and enlarge the access post-intervention, the main access are television, free propagandas, peer education and advertisements column, the rate are 36.6%,30.36%,23.21%,11.61%, respectively.Critical behavior: number of clients in recent one week increased, 92% of them had four or more one-tome clients per week, condom use rate in last sex act increased from 59% to 75%, sometimes condom use rate per month increased from 26% to 31.3%, consistent use rate per month increased from 4% to 26%, never use rate decreased from 13% to 4.5% after intervention, condom use with husband/partners also changed, consistent use rate per month increased from 12% to 34.8%, awareness rate of VCT increased from 16% to 33.9%, consultant rate increased from 2% to 17%, detection rate increased from 2% to 18%.Effectiveness of PE: communication among FSWs increased from 24% to 69.8%, for the topic, those who mentioned HIV increased from 28% to 51.8%.Obtained intervention: they become active to get intervention, especially free condom and propagandas, 78.3% and 48.2%, respectively.Conclusion: after intervention, awareness rate of HIV knowledge among FSWs increased remarkably, attitude changed a lot, self-protection awareness strengthened, high risk behavior decreased, the intervention is effective, feasible, and critical for spread of HIV.