Abstract
<h3>Background/introduction</h3> Female sex workers (FSWs) are often considered as a vector for HIV and other sexually transmitted infections entering the general communities. <h3>Aim(s)/objectives</h3> This study investigated the effectiveness of a resilience-promoting intervention that targets at psychological well-being to facilitate adaptation and safe sexual practices among FSWs which could be an innovative strategy in controlling the spread of these infections. <h3>Methods</h3> Using resilience framework, this intervention consisted of six-weekly sessions focused on awareness, expression and management of emotions, identifying roles and personal strengths, and effective problem-solving skills. The primary outcome of resilience and reduction of sexual risk behaviour were assessed at baseline, post-intervention and 3-month follow-ups through self-administered questionnaires. Difference of the differences between the two groups and intention-to-treat analysis were adopted in the analysis. <h3>Results</h3> 127 FSWs were recruited and randomly assigned to the intervention or usual care (control) groups in a multi-centred randomised controlled trial. There were significant differences on the score on resilience, self-esteem and general mental health status between the two groups at post-intervention and 3-month follow-ups. The rate of condom use improved with time but significant difference between groups was only observed at 3-month follow-ups. Regression models showed that, after controlling for marital status and family size, intervention group assignment (OR = 2.95, 95% CI: 1.19–7.35) and self-efficacy (t = 2.48, p < 0.05) was significantly associated with improved resilience scores. <h3>Discussion/conclusion</h3> The results suggest that the programme was effective in promoting resilience, self-esteem and the mental health status but with less obvious effect on sexual health among FSWs in Hong Kong.
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