To See the Efficacy of Behavioral Interventions on Consistent Condom Use Among Female Sex Workers in Lahore, Pakistan

Abstract

BackgroundSince the beginning of the AIDS epidemic, female sex workers in developing countries have been one of the groups most vulnerable to HIV infection due to their large numbers and rapid change of sexual partners. High rates of other sexually transmitted infections (STIs) and sexual practices such as dry sex or sex during menses further increase the probability of HIV transmission in FSWs. They also are often in a poor position to negotiate safe sex because of social, economic, cultural and legal factors.Method A sample of 300 FSWs from 18 to 45 years of age was recruited using a structured questionnaire. FSWs were randomly assigned to the intervention group and control group. Intervention group attended counseling sessions over a period of one month. Behavioral Interventions were used during counseling sessions including psycho-educational sessions to improve knowledge about HIV prevention and role rehearsal for safe sex behavior, negotiation, communication skills, proper condom use skills, and to help sex partners develop supportive behavior for consistent condom use. Control group didn’t receive any intervention but free condom provision was made possible for both the intervention and control group. Regular follow up sessions were given for 6 months to the participants of intervention and control group.ResultsDescriptive analysis of the baseline interview indicated knowledge about HIV prevention 5.5%, safe sex behavior 10%, negotiation skills 6%, communication skills 6%, and supportive behavior of sex partners 2% that remained the same among females in control group. Females in the intervention group improved knowledge about HIV prevention by 79%, safe sex behavior 70%, negotiation skills 76%, communication skills 75%, and supportive behavior of sex partners 72% at follow up sessions. A multivariate analysis of variance demonstrated increased knowledge about HIV prevention, improved safe sex behavior, improved negotiation skills, improved communication skills and supportive behavior of sex partners (p ConclusionStatistically significant results indicate that behavioral interventions that are gender sensitive, involve sex partners and carried out consistently can effectively enhance consistent condom use among female sex workers.