HIV This Week

Patterson TL, Mausbach B, Lozada R, Staines-Orozco H, Semple SJ, Fraga-Vallejo M, Orozovich P, Abramovitz D, de la Torre A, Amaro H, Martinez G, Magis-Rodríguez C, Strathdee SA. Efficacy of a Brief Behavioural Intervention to Promote Condom Use Among Female Sex Workers in Tijuana and Ciudad Juarez, Mexico. Am J Public Health. 2008;98(11):2051-7.

Patterson and colleagues examined the efficacy of a brief behavioural intervention to promote condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. They randomized 924 female sex workers 18 years or older without known HIV infection living in Tijuana and Ciudad Juarez who had recently had unprotected sex with clients to a 30-minute behavioural intervention or a didactic control condition. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, gonorrhoea, and chlamydia. The authors observed a 40% decline in cumulative sexually transmitted illness incidence (P=.049) in the intervention group. Incidence density for the intervention versus control groups was 13.8 versus 24.92 per 100 person-years for sexually transmitted illnesses combined (P=.034) and 0 versus 2.01 per 100 person-years for HIV (P<.001). There were concomitant increases in the number and percentage of protected sex acts and decreases in the number of unprotected sex acts with clients (P<.05). This brief behavioural intervention shows promise in reducing HIV and sexually transmitted illness risk behaviours among female sex workers and may be transferable to other resource-constrained settings.

Editors’ note: Although the control group received an educational intervention adapted from bi-national counselling guidelines, a comparative brief behavioural activity integrating motivational interviewing and principles of behaviour change produced significant differences in HIV incidence, overall sexually transmitted disease incidence, and unprotected sex with male clients. Sex workers responded to an approach focused on their personal situations with each woman actively identifying barriers to safer sex in her own life and designing potential solutions. This culturally and individually tailored activity has potential implications for sex workers in other resource-constrained settings – it doesn’t take much time and it works, at least for 6 months.