Effectiveness of Culturally Appropriate Initiative on Drug-Related Harm Reduction for Sex Workers on the Thai/Malaysian Border
Worapol Nunun PhD*, Manop Kanato PhD**
Affiliation : * Health Science Program, Faculty of Science and Technology, Songkhla Rajabhat University, Songkhla, Thailand ** Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background and
Objective : Drug use can harm to sex workers. Abstinence intervention, however, may not be appropriate
since drug use fosters their career performance. The objective was to develop the culturally appropriate model for sex
workers participation on drug demand reduction at the Thailand/Malaysian border.
Material and Method: This study was a pre-post quasi-experimental design. Tripartite participation was used to develop the
model aiming to reduce harm regarding drug use. The study carried out during June 2010-May 2011. Data were collected
from 150 key informant interviews, 56 focus group discussions, 22 participant observations in various situations, and
numerous related materials. Descriptive statistics, survival analysis and 95% confidence interval were utilized for quantitative
data. Qualitative data were analyzed by content analysis.
Results : Drug related harm reduction was evaluated at two-week time along implementation period of 12 months. 89.5% of
all sessions introduced could decrease drug related harm. Of all sex workers participated in the study, intended to treat
analysis showed 86.9% success rate (95% CI; 77.1, 96.7). Of these, 32.6% became abstinence, 39.1% reduced most of drug
related harm. 13.0% reduced partial drug related harm either less frequency, less quantity, less concentration, decrease types
of drugs/switch to safe drugs or safer method of administration. 2.2% was infancy stage, which needed further support.
Conclusion : Key success of the model was tripartite participation. With active leaders and strong support, sex workers were
continually motivated to reduce harm regarding drug use.
Keywords : Sex workers, Drug related harm reduction, Culturally appropriate initiative, Thailand
