Combination of Digital and Conventional Intervention for Sexually Transmitted Infections Prevention among Female Sex Workers

Background: Female sex workers (FSWs) are at a high risk of contracting sexually transmitted infection (STI). Mobile health (mhealth) is one intervention that is easily accessible to everyone online and offline, allowing two-way communication through the program. This study aimed to determine the effectiveness of m-health on STI prevention behavior among FSW. Methods: The study was conducted using quasi-experimental design. It included the treatment group and the control group, each of which included fifty-four (54) FSWs selected by purposive sampling. The m-health intervention was conducted in the form of a short comedy movie on YouTube, combined with offline assertive communication training to improve skills in negotiating the use of condoms to the intervention group. Meanwhile, the control group received regular counseling from the local community health center. The Mann- Whitney test was used to compare the knowledge, attitudes, motivation, and behavior among the two study groups. Results: Intervention for six months in the treatment group increased FSWs knowledge score by 4.0 (p=0.00), attitude by 3.9 (p=0.00), and motivation by 12 (p=0.00). The median knowledge, attitude, and motivation scores were 17.38 and 46, respectively. The model is effective onSTI-prevention behavior through motivational mediator variables with a p-value of 0.00. The condom consistency has the highest outer loading value in the STI-prevention behavior construct of 0.71 ≥ 0.4. Conclusion: A combination of digital and conventional health promotion can improve STI prevention behavior by raising knowledge, attitudes, motivation, and condom consistency behavior.