Condom Utilization Among Female Sex Workers in Thailand

Assessing the Value of the Health Belief Model

Abstract

Objective: To perform a small-scale rapid assessment of condom utilization rates among female sex workers (FSW) in various communities in Thailand, to distinguish condom utilization among FSW patrons by country of origin, and to assess the relevancy of constructs from the Health Belief Model in predicting FSW requesting condom utilization by their patrons. Methods: A convenience sampling approached was used among FSW in four cities of Thailand. Survey interviews were conducted in person by native speaking Thai graduate students from Mahidol University of Bangkok. Results: Approximately 70% of the FSW approached participated in the study, resulting in a sample size of 150. FSW requested condom use 63% of the time, while the overall mean proportion of condom use was 51%. Condom use by patrons by country of origin was as follows: Foreign Asian averaged 52%, Western averaged 76%, and local Thai averaged 27%. High levels of perceived fear of infection transmission from a patron, significantly predicted requesting patrons use a condom (Odd Ratio= 11.57, CI95% 4.37 to 30.63). Conclusion: This study found overall condom utilization was 51% among FSW, which is far below the 100% Condom Use goal advocated by the Thailand Ministry of Public Health imitative. Educational efforts need to be focused on the local Thai FSW patron who exhibited the lowest level of condom use. Educational messages may consider including elements of perceived susceptibility to sexbased infections since these perceptions had significant predictive utility in increasing condom use requests by the FSW.