Who’s that SMARTgirl? Reaching Cambodian Female Entertainment and Sex Workers with HIV Prevention Services

Ji Young Lee, Kimberly Page, Ellen Stein, Jennifer L. Evans, Muth Sokunny, Phou Maly, Chhit Sophal, Song Ngak, Lisa Maher, Adam Carrico

Research output: Contribution to journalArticle

Abstract

Engagement in prevention services is crucial to reducing HIV risk among female entertainment and sex workers (FESW), and SMARTgirl is the national social marketing HIV prevention program for Cambodian women engaged in sex and entertainment work. Informed by the Behavioral Model of Vulnerable Populations, three multivariate logistic regression analyses examined correlates of three indices of engagement along the SMARTgirl HIV prevention continuum: (1) receipt of outreach services (past 3 months); (2) being registered as a SMARTgirl member; and (3) SMARTgirl club attendance (past year). Among the 1077 FESW enrolled in nine Cambodian provinces, women working in a brothel or freelance (adjusted odds ratio [aOR] 2.48; 95% CI 1.44–4.26) and those exchanging sex for drugs during the past 3 months (aOR 0.45; 95% CI 0.25–0.81) had significantly lower odds of contact with a SMARTgirl outreach worker. Women who reported having more than ten sexual partners in the past 3 months (aOR 0.54; 95% CI 0.32–0.89) and those who reported binge alcohol use (aOR 0.53; 95% CI 0.29–0.98) had significantly lower odds of being registered as SMARTgirl members. Exchanging sex for drugs was also associated with increased odds of attending a SMARTgirl club (aOR 2.03; 95% CI 1.04–3.98). Novel methods to deliver HIV prevention services are warranted to more effectively reach FESW who exchange sex for drugs, engage in binge alcohol use, report a greater number of sexual partners, and those not working in established work venues.

Original languageEnglish (US)
JournalAIDS and Behavior
DOIs
StatePublished - Jan 1 2019

Fingerprint

Sex Workers
Odds Ratio
HIV
Sexual Partners
Alcohols
Social Marketing
Pharmaceutical Preparations
Working Women
Vulnerable Populations
Logistic Models
Regression Analysis

Keywords

  • Amphetamine-type stimulants
  • HIV prevention
  • Sex work

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Who’s that SMARTgirl? Reaching Cambodian Female Entertainment and Sex Workers with HIV Prevention Services. / Lee, Ji Young; Page, Kimberly; Stein, Ellen; Evans, Jennifer L.; Sokunny, Muth; Maly, Phou; Sophal, Chhit; Ngak, Song; Maher, Lisa; Carrico, Adam.

In: AIDS and Behavior, 01.01.2019.

Research output: Contribution to journalArticle

Lee, Ji Young ; Page, Kimberly ; Stein, Ellen ; Evans, Jennifer L. ; Sokunny, Muth ; Maly, Phou ; Sophal, Chhit ; Ngak, Song ; Maher, Lisa ; Carrico, Adam. / Who’s that SMARTgirl? Reaching Cambodian Female Entertainment and Sex Workers with HIV Prevention Services. In: AIDS and Behavior. 2019.
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abstract = "Engagement in prevention services is crucial to reducing HIV risk among female entertainment and sex workers (FESW), and SMARTgirl is the national social marketing HIV prevention program for Cambodian women engaged in sex and entertainment work. Informed by the Behavioral Model of Vulnerable Populations, three multivariate logistic regression analyses examined correlates of three indices of engagement along the SMARTgirl HIV prevention continuum: (1) receipt of outreach services (past 3 months); (2) being registered as a SMARTgirl member; and (3) SMARTgirl club attendance (past year). Among the 1077 FESW enrolled in nine Cambodian provinces, women working in a brothel or freelance (adjusted odds ratio [aOR] 2.48; 95{\%} CI 1.44–4.26) and those exchanging sex for drugs during the past 3 months (aOR 0.45; 95{\%} CI 0.25–0.81) had significantly lower odds of contact with a SMARTgirl outreach worker. Women who reported having more than ten sexual partners in the past 3 months (aOR 0.54; 95{\%} CI 0.32–0.89) and those who reported binge alcohol use (aOR 0.53; 95{\%} CI 0.29–0.98) had significantly lower odds of being registered as SMARTgirl members. Exchanging sex for drugs was also associated with increased odds of attending a SMARTgirl club (aOR 2.03; 95{\%} CI 1.04–3.98). Novel methods to deliver HIV prevention services are warranted to more effectively reach FESW who exchange sex for drugs, engage in binge alcohol use, report a greater number of sexual partners, and those not working in established work venues.",
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