Abstract
BackgroundFemale sex workers (FSWs) are often considered as the vector, if not reservoir, of HIV and other sexually transmitted infections. Building upon the existing evidence on the role of psychological health in sexual health, the aim of this protocol is to describe a trial investigating the effectiveness of the Personal Resilience and Enrichment Programme (PREP), a resilience-promoting intervention that targets at psychological well-being i.e. self-esteem, self-efficacy and coping, to facilitate adaptation and ultimately safe sexual practices among FSWs, which could be an innovative strategy in controlling the spread of these infections.MethodsA total of 132 FSWs will be recruited and randomly assigned to either the intervention or usual care (control) groups in a multi-centred randomised controlled trial. Based on the resilience framework, this intervention is comprised of six weekly sessions focused on the awareness, expression and management of emotions, identifying roles and personal strengths, and effective problem-solving skills. Complex intervention assessment on both intervention process and effectiveness will be adopted when the primary outcome reduction of sexual risk behaviour and other psychological outcomes include their perceived stress, self-esteem, self-efficacy, coping overall resilience, and psychological distress will be measured at baseline, post-treatment and 3-month post-intervention and differences assessed by ANOVA. The relationship of resilience factors, psychological health and HIV preventive behaviours will be evaluated using structural equation modelling.DiscussionIt is anticipated that this study will increase our understanding of the relationships between individual resilience attributes, positive adaptation, psychological health and sexual health practices. If successful, this programme will provide an innovative direction for HIV prevention by applying the personal resilience factors to promote both psychological well-being and safe sex for this high risk population.Trial RegistrationChiCTR-PRC-13003091
Highlights
Female sex workers (FSWs) are often considered as the vector, if not reservoir, of HIV and other sexually transmitted infections
Under the framework of resilience, the intervention that focuses on individual strengths can potentially expand the understanding and its application to health promotion research by integrating the missing link between psychological and behavioural risk factors
A series of studies conducted came to a similar conclusion that HIV prevention would not be effective if boarder issues such as psychological or contextual ones were not addressed [16,58]
Summary
Female sex workers (FSWs) are often considered as the vector, if not reservoir, of HIV and other sexually transmitted infections. Among various high-risk groups, female sex workers (FSWs), who are associated with a greater number of sexual partners compounded by high mobility, have been identified to play a significant role in the transmission of HIV and other sexually transmitted infections (STIs) [3]. This is due to the fact that FSW could potentially act as a “bridge” to spread the virus to their clients and families of their clients and so forth to the general public, and to the neighbouring regions and vice versa. According to the Global Health Sector Strategy on HIV/AID 2011–15 recently published by the World Health Organisation (WHO), identifying and optimising contextually-tailored HIV prevention programmes for high risks populations was strongly recommended [4]
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