TRAC SUMMARY REPORT PSI DASHBOARD
LAOS (2008): HIV/AIDS TRaC Study Evaluating Condom Use among Female Sex Workers in Champasak, Luang Prabang, Savannakhet, and Vientiane. First Round. Sponsored by:
PSI’s Four Pillars Bottom Line Health Impact * Private Sector Speed and Efficiency * Decentralization, Innovation, and Entrepreneurship * Long-term Commitment to the People We Serve
Research Division Population Services International 1120 Nineteenth Street NW, Suite 600 Washington, D.C. 20036
LAOS (2008): HIV/AIDS TRaC Study Evaluating Condom Use among Female Sex Workers in Champasak, Luang Prabang, Savannakhet, and Vientiane. Secodn Round.
PSI Research Division 2008
© Population Services International, 2009 Contacts: Saysana Phanalasy, Research Manager c/o PSI Laos P.O.Box 8723 Sisattanak District, Vientiane Capital, Lao PDR Phone: (856) 21 35 34 09 Email:
[email protected] Robert Gray, Regional Advisor, PSI Asia c/o PSI Laos P.O.Box 8723 Sisattanak District, Vientiane Capital, Lao PDR Phone: (856) 21 35 34 09 Email:
[email protected] Suggested citation of this work: PSI Research Division, “HIV Prevention Behavior TRaC Study Among Lao Female Sex Workers,” PSI Social Marketing Research Series, (2008) . Laos, 2008
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TABLE OF CONTENTS
1. SUMMARY……………………………………………………………………4 2. MONITORING TABLE……………………………………………………..11 3. MONITORING GRAPHS ………………………………………………….14 4. SEGMENTATION TABLE…………………………………………………15 5. SEGMENTATION GRAPHS………………………………………………18 6. EVALUATION TABLE……………………………………………………..20 7. EVALUATION GRAPHS…………………………………………………..22 8. SUMMARY OF EFFECT TABLE…………………………………………23
SUMMARY Laos, 2008
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BACKGROUND & RESEARCH OBJECTIVES Since 1999, PSI Laos has been implementing HIV prevention programs in Laos, with a focus on populations most at risk, including Female Sex Workers (FSWs) and Men who have Sex with Men/Transgenders (TGs). From 2005, PSI launched a program particularly designed to increase rates of correct and consistent condom use among FSWs with all sex partners, also promoting referral of FSWs to HIV and STI testing and treatment centers operated by partner agencies. To establish baseline indicators of condom use and other target behaviors for this project, in December 2005, PSI Laos conducted an initial Tracking Results Continuously (TRaC) survey in Luang Prabang, Vientiane Capital, Savannakhet and Champasak Provinces. In 2008, a follow-up TRaC survey collected a second round of data to monitor the impact of the intervention on key targeted behaviors among FSWs. The follow-up survey served three functions: 1. Identified and described segments of FSW in terms of consistent condom use with regular, casual and commercial partners; 2. Identified Opportunity, Ability and Motivation (OAM) determinants of condom use with all sexual partners; and 3. Measured changes in key indicators and promoted behaviors and correlated these changes with respondents’ exposure levels to PSI Laos activities. This report summarizes the two rounds of study data. This data will be used to improve PSI’s HIV/STI prevention program serving FSWs in Laos. DESCRIPTION OF INTERVENTION PSI Laos, with funding from the Global Fund and USAID, implements a HIV/STI prevention program targeting FSWs, with an aim of promoting correct and consistent condom use with all sex partners, including regular, casual, and commercial partners. PSI Laos provides HIV and STI prevention products and outreach services to more than 3,000 Lao FSWs in 11 provinces, including Luang Namtha, Oudomxay, Sainyabuli, Luang Prabang, Bokeo, Vientiane Province, Vientiane Capital, Khammouan, Savannakhet, Champasak, and Salavan; this survey samples FSWs in four of these provinces to monitor and evaluate the project’s impact. PSI employs FSWs themselves to conduct outreach to their peers on a weekly basis, focusing on entertainment establishments and other hotspots where FSWs meet with clients. Outreach sessions focus on: 1. 2. 3. 4.
improving FSWs’ ability to correctly and consistently use condoms; building FSWs’ ability to negotiate condom use with all sex partners; promoting general awareness of HIV and STI; and referring FSWs to HIV and STI testing and treatment.
PSI also conducts ‘edu-tainment’ activities to reach potential male clients of FSWs; in particular, male Lao migrant workers who often patronize commercial sex workers. PSI’s Mobile Education Entertainment Teams (MEET) conduct ‘edu-tainment’ on longdistance public buses and in entertainment establishments, focusing on condom use and HIV and STI awareness and prevention. METHODOLOGY Laos, 2008
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This endline survey was conducted in April 2008. Due to the heterogeneity of the FSW population in Laos, as well as the difficulty of accessing FSWs who work in a variety of venues and serve different clientele, Respondent Driven Sampling (RDS) was used to recruit respondents. Although PSI Laos conducts program activities in 10 provinces, only four out of these ten provinces were sampled for the survey. These four provinces were chosen to serve as a representative sample of the larger 10 province program area. A sample size of 755 was established as the minimum number of respondents necessary to show statistical significance in key indicators. The survey monitored changes in key indicators between baseline (2005) and endline (2008), segmented respondents into consistent versus inconsistent condom users to determine the main determinants of the target behaviors, and measured program impact by evaluating the relationship between exposure to the program and measured changes in behaviors and determinants of behaviors. A modified version of the 2005 questionnaire was used during this second round of data collection (see appendix). Data was analyzed in SPSS using multivariate techniques.1 The risk group was defined as Female Sex Workers, ages 18 – 28 years old, who sell sex for money. MONITORING TABLE: MAIN FINDINGS The monitoring table tracks changes in key indicators from 2005 to 2008. The most significant findings are listed below: :: Behavior Commercial Partners2: Consistent condom use3 with commercial partners in the last month significantly increased from 82% in 2005 to 89.3% in 2008 (p
