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

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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Acknowledgments

This study is funded by the US National Institutes of Health (NIH) National Institute on Drug Abuse (Grant No. 1R01 DA033672; Page & Stein, PIs). We would like to thank our research collaborators in Cambodia as well as the women who participated in the SMARTgirl program.

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Correspondence to Adam W. Carrico.

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All authors of the present manuscript declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee(s) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lee, J., Page, K., Stein, E. et al. Who’s that SMARTgirl? Reaching Cambodian Female Entertainment and Sex Workers with HIV Prevention Services. AIDS Behav 24, 738–745 (2020). https://doi.org/10.1007/s10461-019-02532-6

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Keywords

  • Amphetamine-type stimulants
  • HIV prevention
  • Sex work