Behavioral Interventions for Cambodian Female Entertainment & Sex Workers Who Use Amphetamine-Type Stimulants

Conditional cash transfer (CCT) and cognitive-behavioral treatments are evidence-based approaches to reduce stimulant use and sexual risk taking. We describe the adaptation and implementation of sequential behavioral interventions for Cambodian female entertainment and sex workers (FESW) who use amphetamine-type stimulants (ATS): (1) a 12-week CCT intervention; and (2) a 4-week cognitive-behavioral aftercare (AC) group. 

An ongoing cluster randomized stepped wedge trial in 10 Cambodian provinces is enrolling FESW with confirmed recent ATS use to examine the effectiveness of CCT + AC. In the first six provinces, 138 of the 183 eligible FESW (75 %) enrolled in CCT and completed a median of 25 (interquartile range 9-32) of the 36 urine screening visits. 

Of the 84 participants who were eligible for AC, 79 completed at least one session (94 %) and 57 completed three or more sessions (68 %). Culturally tailored behavioral interventions to reduce ATS use and optimize HIV prevention are feasible in resource-limited settings.

Purchase full article at: 

By:  Carrico AW1,2, Nil E3, Sophal C4, Stein E5, Sokunny M3, Yuthea N6, Evans JL4, Ngak S3, Maher L7, Page K8.

• 1University of California, San Francisco School of Nursing (https://nursing.ucsf.edu/), 2 Koret Way, N511 M, San Francisco, CA, 94143, USA. adam.carrico@ucsf.edu.
• 2University of California, San Francisco Center for AIDS Prevention Studies, San Francisco, CA, USA. adam.carrico@ucsf.edu.
• 3Family Health International 360 (FHI 360), Phnom Penh, Cambodia.
• 4Department of Mental Health and Substance Abuse, Ministry of Health, Phnom Penh, Cambodia.
• 5University of California, San Francisco Global Health Sciences, San Francisco, CA, USA.
• 6National Authority for Combatting Drugs, Phnom Penh, Cambodia.
• 7Kirby Institute for Infection and Immunity, UNSW Australia, Sydney, Australia.
• 8University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
• J Behav Med. 2016 Jan 18.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Factors Associated with Induced Abortion among Female Entertainment Workers: A Cross-Sectional Study in Cambodia

OBJECTIVE:

To explore risk factors associated with induced abortion among sexually active female entertainment workers (FEWs) in Cambodia.

PARTICIPANTS:

This study included 556 FEWs aged 18-47 years randomly selected from entertainment establishments in the two cities in 2014 using a two-stage cluster sampling method. Data were collected through face-to-face interviews using a structured questionnaire.

RESULTS:

Of the total sample, 45.6% reported currently using a contraceptive method with condom (42.4%) being the most common method, followed by pills (25.6%). One-fourth (25%) of the respondents reported having been pregnant at least once, and 21.4% reported having at least one induced abortion during the time working as a FEW. After controlling for other covariates in a multivariate logistic regression model, FEWs with a history of induced abortion remained significantly more likely to be currently working in a karaoke bar, to have worked longer as a FEW, to have had a greater number of sexual partners in the past 12 months, to be currently using a contraceptive method, to be able to find condoms when they needed them, and to report inconsistent condom use with non-commercial partners in the past 3 months.

CONCLUSIONS:

This study highlights the high rates of unwanted pregnancies that ended in induced abortions among FEWs in Cambodia. Access of FEWs to quality sexual and reproductive healthcare services is deemed a high priority. Integrated interventions to improve sexual and reproductive health among these vulnerable women should be tailored to reach the most-at-risk groups.

Full article at:  http://goo.gl/GIsphP

By:  Siyan Yi,1,2 Sovannary Tuot,1 Pheak Chhoun,1 Khuondyla Pal,1 Khimuy Tith,1 and Carinne Brody2

¹Research Center, KHANA, Phnom Penh, Cambodia

²Center for Global Health Research, Public Health Program, Touro University California, Vallejo, California, USA

Correspondence to Siyan Yi; Email: moc.rotcod@nayis

 

More at:  https://twitter.com/hiv_insight

And: http://twitter.com/Prison_Health

Effectiveness of a Peer-Assisted Multicomponent Behavioral Intervention in HIV Risk Reduction among Female Entertainment Workers in China

This study examined the effectiveness of a behavioral intervention that combined cognitive and social influence approaches. 

The intervention consisted of small group sessions targeting HIV knowledge, protection motivation, behavioral skills, and social influences of risk reduction. The control was an attention-controlled HIV/STI health education and counseling. Two-group comparisons were conducted to assess the effectiveness of the intervention; risk reduction over time was analyzed to determine the sustainability of the effectiveness. 

The analyses revealed that the intervention was effective in reducing/increasing HIV risk/protective behaviors and the effect was sustainable. While participants in the control reported a greater reduction/increase in risk/protective behaviors 3-month post-intervention, the initial strong effect quickly faded and completely disappeared 12-month post-intervention. 

By contrast, the moderate initial effect of the intervention was not only sustained but actually strengthened over time. The intervention was well received by participants and holds promise for HIV risk reduction behavior change among female entertainment workers in China.

Purchase full article at: http://goo.gl/EEgLMF

By: Yang X1, Xia G2.

• 1Old Dominion University, Norfolk, Virginia.
• 2Shanghai Academy of Social Sciences.  

More at:  https://twitter.com/hiv_insight

Characteristics, Risk Behaviors & Factors Associated with Abortion among Female Entertainment Workers in Cambodia

Background

Linkages between HIV and reproductive health (RH) among female entertainment workers (EWs) have not been addressed well in most developing countries. In Cambodia, there has been considerable research on HIV epidemiology among EWs. However, there have been limited studies on RH and specifically factors related to abortion. We examine socio-behavioral characteristics, and RH practices as determinants of abortion among Cambodian EWs.

Methods

A survey was conducted in Siem Reap and Battambang and Phnom Penh provinces/city among EWs in September 2012. Trained female interviewers administered the survey to 595 EWs. Two-stage cluster sampling was used to select EWs. Bivariate associations were examined using chi-squares; univariate and multivariate logistic regression were used to assess factors independently associated with reporting having at least one abortion while working as an EW.

Results

Three-quarters (75 %) of EWs were sexually active, of which nearly one third reported at least one abortion while working as an EW. About 40 % of EWs reported recent an abortion in the past six months. Contraceptive use in the past year was low. Factors found to be independently associated with reporting a recent abortion included: ages 25–29 (OR = 2.2, 95 % CI: 1.2–4.0), living with spouse/cohabitated partner (OR = 2.2, 95 % CI: 1.1–4.2), longer duration of entertainment work (OR = 4.8, 95 % CI: 2.5–9.2), higher number of partners (OR = 4.4, 95 % CI: 2.2–8.7) and being a karaoke worker (OR = 2.2, 95 % CI: 1.1–4.4).

Conclusion

This study highlights a high proportion of EWs reporting abortion. While HIV vulnerability of EWs has been clearly established, broader RH needs have gone largely unrecognized and not prioritized. Though HIV/RH integrated initiatives have been introduced by the HIV program, challenges for EWs with multiple risks from professional and partners are profound. Therefore, there is an urgent need for practical programmatic approaches to help address their RH needs.

Read more at: http://ht.ly/RPQMF HT https://twitter.com/uclafsph

More at:  https://twitter.com/hiv_insight