BEHAVIORAL INTERVENTIONS FOR REDUCTION OF SEXUALLY-TRANSMITTED DISEASE HIV TRANSMISSION AMONG FEMALE COMMERCIAL SEX WORKERS AND CLIENTS IN BALI, INDONESIA

Objective: To describe and evaluate a behavioral intervention targeted to low-price female commercial sex workers (CSW) in large brothel com plexes, their pimps, and their male clients. Design and methods: Field work was conducted during 1994 in Ball, Indonesia. Intervention activi ties included an education program for CSW, pimp training, condom sale s and distribution, and client media. Theoretical perspectives guiding the intervention were the Health Belief Model and social cognitive th eory. Baseline and evaluation surveys were conducted to evaluate the i ntervention. Results: Both AIDS and sexually transmitted disease (STD) knowledge increased significantly over the intervention period. Condo m use for vaginal sex with paid partners the day before the interview increased substantially in the two intervention areas: 18-75% and 29-6 2%. Condom use also increased in the control area, although the differ ence between baseline and evaluation measures was smaller. Multivariat e analyses indicated that programmatic factors such as attendance at e ducation sessions and reading the project brochure were related to con dom use. Conclusions: Increasing community knowledge and awareness amo ng low-price CSW, pimps, and clients regarding AIDS and STD using trai ned outreach workers is feasible and effective. In summary, this study has documented the effectiveness of a behavioral intervention for CSW and their clients.