Risk perception for STD and behaviour changesin sex professionals of Manacapuru municipal ityin the Amazons, Brazil

Abstract

Introduction: A comprehensive project for STD/HIV control in sex professionals (FSW) was started in Manacapuru municipality in the Amazons, Brazilat the end of the year 1998, focusing the health actions to a high risk group of the population in order to support the disease control in the whole community.Objectives: Health actions encompassed free of charge diagnosis and treatment of STD, health education about these infections as well as promotion ofhealth and high quality condom delivery at minimum prices in order to enforce the negotiation abilities about safe sex with the clients. Methods: Theproject was supported by using “pairs“ that undertook health education and promotion of activities on condom use in pubs, cafes, streets and meetingplaces. Sustainability of this project is achieved from the low price condom sells. A probabilistic sample was obtained from an estimated of 500 FSW,stratified by meeting points and considering a STI minimum prevalence of 5%, CI=95% and standard error of 2%. A KAP questionnaire was applied withan interval of two years in 1991 and 2001 for assessing the project. Results: The monitoring study in 2001 has shown that the risk perception for STI andthe using of condom have been significantly increased among FSW, which is consistent with the low levels of STI prevalence in this group and thedecreasing trend among the population in this municipality. The efficiency of the project has been shown in the achieved behavioural variations such asincreasing of the condom use in every modality of sexual contact (from % to 77,7%), increment in the adequate use of condom (10,1% to 59,0%) and thehigh percent of women that show their condoms at the time of the questionnaire (14% to 54,7%); however, the condom use in unchanging couple isrelatively low. Conclusion: Data in this study show the efficiency of the educational program by using the promotion of an adequate use of condom forprevention of STI/HIV in sex workers professionals and their clients in Manacapuru. Health interventions on these sex professionals appear to besuccessfully possible and promissory result in STD control programmes can be achieved even with partial increasing of condom use.