Evaluation of key messages to increase the use of condoms in sex workers. A quasi-experimental study.

Educational strategies to increase condom use among female sex workers in Tijuana Mexico were evaluated in a quasi-experimental study. There are approximately 15000 working prostitutes in Tijuana 89% of whom experience vaginal penetration with an average of 12 men/week. A pretest indicated that only 8% of these women were aware condoms can prevent acquire immunodeficiency syndrome (AIDS) and condom use was practiced by 39% in the month preceding the pretest. Given the low educational level of this target group (average of 2 years of elementary school) and preference for graphic materials comic books pamphlets and posters were selected to convey the campaigns messages that: 1) AIDS is a sexually transmitted disease 2) condom use can prevent infection 3) AIDS can be transmitted perinatally and 4) prostitutes who use condoms are responsible mothers. During the 2-week intensive phase of the campaign 20000 pieces of educational material were distributed. To evaluate the effectiveness of this campaign 184 prostitutes were randomly selected for a postsurvey. Condom use in the preceding month increased from 39% 6 months before the intervention to 65% 1 month after the pretest to 96% in the postsurvey of the proportion of prostitutes who were aware that condoms can prevent sexually transmitted diseases. The identification of relevant key messages for this campaigns educational materials through focus group discussions with prostitutes is credited with the interventions effectiveness. The program is now being applied in other Mexican cities in a similar effort to increase condom use among female sex workers.