Impact of time perspectives on texting intervention to reduce HIV/STI transmission among female sex workers in Tijuana and Ciudad Juarez, Mexico

Abstract

Text messages may sustain post-counseling gains in behavioral improvements and reduce HIV/STI incidence. However, their effectiveness may depend on the messages' time perspective and characteristics of the individual. We evaluated the impact of time perspective on a text messaging intervention designed to maintain improvements in safer sex practices among drug-using and non-drug-using female sex workers (FSWs) in Tijuana (n = 141) and Cd. Juarez (n = 129), Mexico. FSWs received the efficacious Mujer Segura intervention, and were randomized to receive safer sex maintenance text messages with either a short-term or future-oriented time perspective. The outcome was HIV/STI incidence rate over 6-month follow-up. In Tijuana, combined HIV/STI incidence density was lower among FSWs in the FUTURE group (31.67 per 100 py) compared to women in the SHORT-TERM group (62.40 per 100 py). Conversely, in Cd. Juarez, HIV/STI incidence density was lower (although non-significant) among FSWs in the SHORT-TERM group (19.80 per 100 py) compared to those in the FUTURE group (35.05 per 100 py). These findings suggest that future-oriented text messages may sustain post-counseling improvements in sexual risk behavior among FSWs, but findings may vary by FSWs' characteristics (e.g., drug use), and by region and context.

The Use of Information and Communication Technologies by Sex Workers to Manage Occupational Health and Safety: Scoping Review

“…Of the 41 studies selected for review, 7 were experimental (5 were randomized controlled trials) [17][18][19][20][21][22][23], 19 were observational studies [10,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] [55,56]. Each paper was a unique separate study, meaning that no two papers discussed the same data.…”

Hazardous Alcohol Consumption Moderates the Relationship Between Safer Sex Maintenance Strategies and Condomless Sex With Clients Among Female Sex Workers in Mexico

“…The sample consisted of 602 FSWs in Tijuana and Ciudad (Cd.) Juarez enrolled in a 24-month text messaging behavioral maintenance intervention ( Mujer Saludable Siempre [MSS]; Healthy Woman Forever) following brief sexual risk reduction counseling (Patterson et al, 2019). To be eligible for MSS, participants had to be cisgender female; at least 18 years of age; self-identify as a FSW; report having traded sex for drugs, money, shelter, or other material benefit in the previous month; report condomless vaginal or anal sex with a client in the previous month; report no previous HIV-positive test result; own a cell phone; and agree to be tested for HIV/STIs at baseline and follow-up assessments.…”

“…Participants were recruited between January 2016 and December 2017, primarily through time-location sampling (Patterson et al, 2019). Outreach workers canvassed sex work venues/locations frequented by FSWs (e.g., bars, streets).…”

“…Juarez. Eligible women were scheduled for a 2-hour baseline visit, which included a 60 minute face-to-face, computer-assisted personal interview (Nova Software), followed by the Mujer Segura counseling session (30-45 minutes; Patterson et al, 2019). Participants were reimbursed the equivalent of $30 USD for the session.…”

“…We hypothesized that the relationship would be weaker for FSWs who meet criteria for hazardous alcohol consumption. To evaluate this hypothesis, we used baseline (precounseling) data from an efficacy trial of an intervention designed to sustain behavior changes following sexual risk reduction counseling (Patterson et al, 2019). Our rationale for using baseline data is twofold.…”