Effect of health education and condom promotion on behavioral change among low socioeconomic prostitutes in Mae Sot, Tak, Thailand

Abstract

A study was conducted to determine the effect of preventive educational efforts among 621 female prostitutes in Mae Sot, Tak Province, in 1989. The intensive health education program at a personal level and free condom distribution to the prostitutes began in March and June 1989, respectively. The proportion of prostitutes' sexual partners using condoms increased from 13.5% in January 1989 to 50.4% by December 1989. The reported increase in condom use was supported by the decline in the incidence rate of gonorrhea among the prostitutes during the same period. Anal intercourse was not commonly practised in these women and decreased from 9.7% in January to 1.8% in December 1989. None of the prostitutes interviewed throughout the year reported using intravenous drugs, nor reported having a steady sexual partner who was an intravenous drug user. None out of 248 prostitutes tested in January 1989 were HIV-1 seropositive. After that throughout the year, 15 of 373 (4.0%) additional prostitutes in this area were found to be seropositive on their first test. Ten out of 405 (2.5%) initially-seronegative prostitutes who were subsequently tested at 3-month intervals became seropositive. The effect of health education and condom promotion among our study prostitutes was modest. Similar studies are needed to evaluate the programs in other settings of Thailand, particularly in areas with high prevalence of HIV-1 infection.