Promoting condoms for oral sex: impact on pharyngeal gonorrhea among female brothel-based sex workers.

Abstract

Low condom use for oral sex among female brothel-based sex workers in Singapore has led to a rise in pharyngeal gonorrhea. The goal of the study was to evaluate a program promoting the use of condoms for oral sex. We used the time-series design to compare condom use and pharyngeal gonorrhea trends before and after program intervention in 1996 and the pretest-posttest matched control group design to determine the impact of brothel interventions on sex workers. Consistent oral condom use increased significantly from 42.2% in 1996 to 89.9% in 2000, with a corresponding decline in pharyngeal gonorrhea (in comparison with no significant changes before intervention). Among sex workers in brothels with interventions there was a 10.8% absolute increase in condom use, compared with an 11.7% decrease in condom use in the control group. The gonorrhea incidence rate was also significantly much lower in the intervention group than in the control group (adjusted risk ratio: 0.22; 95% CI: 0.06-0.78). The intervention increased oral condom use, with a decline in the incidence of pharyngeal gonorrhea.