Narrative explorations and self-esteem: research, intervention and policy for HIV prevention in the sex industry in Thailand.

Abstract

This paper reports on a project that integrates basic behavioral and need assessment research with program design, implementation and evaluation to promote consistent condom use in the sex industry of Thailand. The project structure consisted of Phase I, which provided a detailed psychosocial investigation into the factors influencing condom use by female sex workers in Thailand. Phase II translated the research findings of Phase I into an operational intervention. This involved an integrated series of stages including pre-program needs assessment, intervention design, implementation, evaluation, and finally dissemination and policy integration. As a basis for open discussion and personal exploration the use of dramatic narrative scenarios on video were used to depict the problems experienced by sex workers. This program was implemented in high and low-income establishments in central Thailand; evaluation was performed through pre/post-test, intervention and control, and quasi-experimental design. Findings demonstrated an increase in the consistency of condom use over a period of 1 month among the low-income intervention group, from 66% (pre-test) to 86% (post-test), while there was no significant change observed among the sex workers in the control group.