3. TRaC BELIZE (2010)
Tracking Results Continuously
HIV/AIDS TRaC Study evaluating
condom use among Female Sex
Workers (FSW) and Men who have sex
with Men (MSM) in Belize City, Cayo,
Orange Walk, Corozal Town and Stann
Creek (Second round)
4. STUDY OBJECTIVES
Monitoring:
Behavior of variables and indicators
through time.
Segmentation:
What are the factors and
characteristics that can influence
healthy behaviors.
Evaluation:
Establish the effectiveness of the
activities of the PASMO Programes.
5. PASMO’S IMPACT
*
Exposed
exposed
Not
PASMO can determine if changes in indicators can be attributed to their program or
if it is a general change. It can also be determined if it was due to mass media
intervention messages or IPC programs
8. Belize City
Place: Cayo
Orange Walk
Corozal Town
Stann Creek
FSW Methodology: 2007: Multi stage clustered sample
2010: Census
Sample: 2007= 85 2009=252
Dates: Feb 2007 – Aug 2010
Characteristics: Venue/fixed 2007= 53% 2009=88%
Ambulatory 2007= 37% 2009=12%
9.
10. FSW that Used Condom in the last Sexual Encounter
Total Cases used condom total cases used condom
2007 (%) 2009 (%)
2007 2007 2009 2009
Belize District 50 50 100 99 55 55.6
Cayo 1 1 100 38 26 68.4
Orange Walk 25 25 100 54 39 72.2
Corozal Town 7 7 100 24 21 87.5
Stan Creek 2 2 100 37 27 73
TOTAL
85 85 100 252 168 66.7
13. 2007 (N=82) 2009 (N=252)
44.3%
Lubricant use during last sex **
27.6%
57.7%
Lubricant use sometimes last
month ***
27.6%
14.
15. 2007 (N=82) 2009 (N=252)
92.9%
Important to get tested (ns)
95.2%
75.8%
Tested last year (ns)
68.5%
95.7%
Received results (ns)
97.0%
75.6%
Post counselling (ns)
64.8%
16. 2007 (N=82) 2009 (N=252)
77.5%
Carried a condom ***
46.9%
89.6%
Can find a condom within 10
minutes (ns)
84.1%
22. Did not use a Used a condom
condom
Condom use
during last sex
23. - +
Condom use probability
* = p<.05
Condom use
** = p<.01
*** = p<.001 during last sex
ns = non significant
24.
25. WHICH FACTORS DETERMINE NOT USING
A CONDOM USE IN FSW WITH ANY CLIENT?
- +
Probability of NOT using a condom
Did not use * = p<.05
** = p<.01
Condom last sex *** = p<.001
ns = not significant
26.
27. • Inconsistencies in program activities in 2010 may have affected the success
in target populations’, knowledge and behavior.
• Taking into account that FSW report an increase in the number of stable
partners over the past 12 months program messages should focus on the
importance of condom use with all partners at every sexual contact.
• Given the positive segmentation result of FSW carrying a condom linked to
the increased use of condoms programs should advocate carrying a
condom and provide supporting materials (e.g. condom cases) to promote
this behavior.
28. • The fall in lubricant use provides an opportunity for addressing the
component of water based lubricants use in programming. The information
and materials distributed should underscore the increased risk of not only
engaging in unprotected sex but that without lubricants. The exposure to
materials from the IPC activities appears to be successful and should be
continued.
• There is a need for sustained activities among the FSW. Continued
emphasis should be placed on using condoms with all partners and
changing the perception of condoms making sex less pleasant. In this
respect, the protective qualities of condoms should be highlighted to clients.
More research is needed on the appearance, flavor and other consumer
qualities of the favorite brands of condoms with results of this study serving
as a basis for possible changes in procurement and distribution policies.
35. 2007 (N=80) 2009 (N=227)
Lubricant use during last sex 62.5%
***
90.1%
Lubricant use sometimes last 65.7%
month ***
87.9%
Think that lub + condom 49.4%
reduce risk (ns) 58.8%
36. 2007 (N=80) 2009 (N=227)
Knows where to get tested (ns)
93.2%
85.2%
Tested last year (ns)
72.7%
77.4%
Received results (ns)
96.5%
96.0%
Post counselling **
71.4%
91.2%
37. 2007 (N=80) 2009 (N=227)
57.4%
Carried a condom (ns)
61.7%
65.3%
Can find a condom within 10
minutes (ns)
74.3%
39. 2007 (N=80) 2009 (N=227)
22.2%
VIVE is their favorite brand *
38.9%
100.0%
An HIV+ person can look
healthy **
87.0%
40.
41. - +
Condom use probability
* = p<.05
Condom use
** = p<.01
*** = p<.001 during last sex
ns = non significant
42.
43. - +
Probability of NOT using a condom
Did not use * = p<.05
** = p<.01
Condom last sex *** = p<.001
ns = not significant
44.
45. • Taking into account that MSM report an increase in the number of
occasional partners over the past 12 months, program messages should
focus on the importance of condom use with all partners at every sexual
contact. Program messages should target issues arising out of concurrent
and multi partnering relationships.
• Vive Lubricants have not been in the market during the program years.
Despite this product absence, the use of lubricants both at last sex and
consistent use significantly increased. This suggests that there is a demand
for the product and should therefore be considered for reintroduction.
46. • Positive health seeking behaviors that include getting tested for HIV with
post-counseling and seeking treatment for STIs significantly increase.
Programs should maintain activities that promote these positive goal-
healthier behaviors.
• Continued emphasis should be placed on changing the perception of
condoms making sex less pleasant. In this respect, the protective qualities
of condoms should be highlighted. More research is needed on the
appearance, flavor and other consumer qualities of the favorite and other
brands of condoms with results of this study serving as a basis for possible
changes in procurement and distribution policies.