Six-Month Follow Up Data from RCT Testing Brief
Alcohol Reduction Intervention with
Female Sex Workers in Mombasa, Kenya
Presenter: Peter Mwarogo FHI 360
IAS 2013 Kuala Lumpur Malaysia July, 2013
Study Objective
• To investigate whether FSWs at drop-in centers in Mombasa,
Kenya, who report harmful or hazardous alcohol intake and
participate in a brief alcohol intervention, will reduce their
alcohol use and incidence of STIs, HIV, and sexual violence, as
well as increase their condom use.
Study Design
• Recruited FSWs through APHIA Plus, Mombasa
• 818 participants enrolled March-October 2011
• Participants randomized to 6-month alcohol intervention, or
6-month nutrition intervention
• Alcohol intervention based on an adaptation of WHO brief
intervention
• Data collection at baseline, 6 month, and 12 month follow-up
– Clinical testing for HIV, trichomoniasis, gonorrhea,
chlamydia
– Behavioral survey on alcohol, condom use, physical and
sexual violence
• 6-month follow-up rate: 86% (n=701)
Study Sample Characteristics at Baseline
Intervention N(%)
411 (50.2)
Control N(%)
407 (49.8)
TOTAL N(%)
818
Age (years)
18-24
25-29
30-34
35-54
163 (39.7)
124 (30.2)
65 (15.8)
59 (14.4)
153 (37.6)
131 (32.2)
65 (16.0)
58 (14.3)
316 (38.6)
255 (31.2)
130 (15.9)
117 (14.3)
Education
Never attended school
Primary school, any
Secondary school, any
Post-secondary school, any
12 (2.9)
212 (51.6)
149 (36.3)
38 (9.2)
21 (5.2)
204 (50.1)
146 (35.9)
36 (8.8)
33 (4.0)
416 (50.9)
295 (36.1)
74 (9.0)
Religion
Christian
Muslim
None
296 (72.0)
115 (28.0)
0 (0.0)
296 (72.7)
109 (26.8)
2 (0.5)
592 (72.4)
224 (27.4)
2 (0.2)
Marital status
Never married
Currently married
Separated, divorced, widowed
187 (46.1)
14 (3.4)
205 (49.5)
190 (47.1)
14 (3.5)
199 (49.4)
377 (46.6)
28 (3.5)
404 (49.9)
HIV Positive
83 (20.2)
83 (20.4)
166 (20.3)
Alcohol Use at 6 Months
Intervention N(%)
347 (49.5)
Control N(%)
354 (50.5)
TOTAL N(%)
701
Alcohol use in last 30 days
Every day
At least once per week
Less than once per week
Never
12 (3.5)
124 (35.7)
25 (7.2)
186 (53.6)
34 (9.6)
207 (58.5)
20 (5.6)
93 (26.3)
46 (6.6)
331 (47.2)
45 (6.4)
279 (39.8)
Sex while feeling drunk in last 30 days
Most of the time
Sometimes
Rarely
Never
10 (3.8)
48 (18.3)
38 (14.5)
166 (63.4)
33 (10.6)
99 (31.8)
67 (21.5)
112 (36.0)
43 (7.5)
147 (25.7)
105 (18.3)
278 (48.5)
Binge drinking (3+ drinks on one occasion)
Most of the time
Sometimes
Rarely
Never
25 (7.2)
34 (9.8)
33 (9.5)
255 (73.5)
142 (40.1)
60 (16.9)
34 (9.6)
118 (33.3)
167 (23.8)
94 (13.4)
67 (9.6)
373 (53.2)
Any binge drinking (5+ drinks) before sex with client1
21 (8.1)
76 (24.7)
97 (17.1)
Any binge drinking (5+ drinks) before sex with
nonpaying partner2
9 (4.2)
36 (14.7)
45 (9.8)
1Women
2Women
who had sex with client in last 30 days
with non-paying partner
Sexual and Physical Violence at 6 Months
Intervention N(%)
347 (49.5)
Control N(%)
354 (50.5)
TOTAL N(%)
701
Forced sex by client in last 30 days one or
more times
45 (17.4)
65 (21.1)
110 (19.4)
Forced sex by nonpaying partner in last 30
days one or more times
72 (26.5)
75 (27.5)
147 (27.0)
Beaten/physically abused by client in last 30
days one or more times
16 (4.6)
16 (4.5)
32 (4.6)
Threatened/verbally abused by client in last
30 days one or more times
72 (20.7)
107 (30.3)
179 (25.6)
Robbed/not paid by client in last 30 days one
or more times
59 (17.0)
82 (23.2)
141 (20.1)
Beaten/physically abused by non-paying
partner in last 30 days one or more times
40 (14.7)
57 (20.9)
97 (17.8)
Key Observations
• Participants are young, have little education, are predominantly Christian,
and many are separated/divorced
– Intervention and control groups have similar demographic
characteristics
• Alcohol use at 6 months was reported be lower in intervention than control
group, regarding:
– Alcohol use in past 30 days
– Sex while feeling drunk in past 30 days
– Binge drinking 3+ drinks; Binge drinking 5+ drinks before sex
• Low rates of incident STIs and HIV seroconversion from baseline to 6 month
follow-up
• Condom use is high with paying clients and lower with non-paying partners
• Physical and sexual violence by clients and partners is common