Investigation On Behavioral Intervention For AIDS Among Female Sex Workers In Places Of Public Entertainment

Objective To investigate the female sex workers in Wuhu City Anhui Province,and find out how much they know about knowledge,behavior on AIDS and the use of condoms and by using a practicable model of AIDS risk behavioral intervention to provide health education and condom using promotion among female sex workers in public entertainment places ,it is likely to increase their STD/AIDS prevention knowledge,promote safe sexual activities,advance standard medical behaviors and reduce HIV transmission between female sex workers and sexual partners . Then sum up experience of intervention in such places and provide theoretic basis and new method for 100% condom using promotion among the target population.Methods Comprehensive intervention was carried out in public resorts with epidemic- ological intervention study method.First,we adopted conveniental sampling method and chose 75 middle scale and low scale resorts of Wuhu City in Anhui Province. Question- naire investigation was used to all of the female sex workers in each resort.The main investigating content included knowledge on AIDS,performance characteristics and the use of condoms.Then publicity and education were carried out through a variety of AIDS health education and behavioral intervention modus on female sex workers. 500 female sex workers were chosen and given the same investigation was again given on their knowledge, attitudes and behavior before and after the intervention.To understand the influence of the interevation on their knowledge, attitudes and behavior, as well as changes in condom use, so as to evaluate the feasibility and the effectiveness of the comprehensive intervention.Results1. Before the intervention, a total of 500 female sex workers were investigated and 53.40% of them came from Anhui Province, 46.60% came from Other Provinces; 86.40% came from middle scale resorts, 13.60% came from low scale resorts.2. All of them basically understood the prevention knowledge on AIDS and the knowledge of condom using (the correct awareness are 74.68% and 77.80% respectively).3. The average age of those who first took commercial sex activity was 22.09±4.69,82.20% female sex workers admitted using condom in the latest commercial sex,the main reason they failed to use condoms was that clients were reluctant to use and the rate of condom being used in every commercial sex during the latest month is 53.00% ,while 33.90% admitted using condom in the latest sex and 19.10% used it every time during the latest month among the 277 workers having sexual relations with their spouses or cohabitant boyfriends.4. After the intervention,500 female sex workers were investigated and 51.40% of them came from Anhui Province,48.60% came from Other Provinces,86.00% came from middle scale resorts,14.00% came from low scale resorts,The population characteristics has no significant difference compared with that before the interevation(p>0.05).5. Evaluation after the intervention indicated that the female sex workers'knowledge on AIDS,attitudes and behavior have changed remarkably.Their communication and consultation ability to use condoms with clients has been improved significantly too.In comparision with the assessment of the end and the baseline survey,the awareness rate of preventing AIDS rose to 88.42% from74.68%.The rate of condoms being used correctly up to 90.60% from 77.80%.And the ratio of female sex workers using condoms every time in the latest month during each sex action in the last six months up to 60.80% from 53.00%. Among the 277 wokers that having sexual relations with their spouses or cohabitant boyfriends,the rate of condom using in the latest sex up to 46.80% from 33.9%,and the ratio of condom using everytime in the latest month up to 28.00% from 19.10%.Differences between the interventions have statistical significance. The on-time of CSW that from middle scale resorts and low scale resorts was shorten obviously after the intervention,and the differences between before and after the intervention have high statistical significance. The rate of complete decision-making power of condom using in CSW's commercial sex behavior was 85.60% before the intervention while the rate became 90.60% after the intervation. Then the following were"advise introduced by themselves,and the other side agreed"(5.20% and 2.40%)and"decisions were made by both sides"(9.20% and 7.00%),the differences between before and after the intervention have statistical significance.The most CSW would choose going to the regular hospitle for treatment if they found they have be infected with the venereal disease. Also they will stop their sex service and wouldn't work untill the treatment to be end.Conclusions1. Before the intervention,female sex workers knew less about the knowledge of STDs and HIV/AIDS,and were imperceptive about the risk of being infected with HIV.There were quite a lot mistakes about their condom using.HIV related high-risk behaviors also existed.Comprehensive intervention need to be carried out urgently,widely and deeply in this population .2. Quantitative analysis of the influential factors for condom use indicates that the obstruction of condom use during the commercial sex activities was mainly from the female sex workers'clients,and the ability of female sex workers to negotiate the condom use with their clients is usually limited.The measures aiming at female sex workers should be performed in the process of HIV/AIDS prevention.3. Comprehensive intervention which includes propaganda,condom's popularization and providing of venereal clinic can effectively not only improve female sex workers' knowledge of STDs and HIV,but also improve the rate of condom use, and reduce the infection of STD/HIV as well as the sexual transmitted HIV, such the intervention is expected to have significance in its popularization and application.