Promoting Condoms for Oral Sex

Background Low condom use for oral sex among female brothel-based sex workers in Singapore has led to a rise in pharyngeal gonorrhea. Goal The goal of the study was to evaluate a program promoting the use of condoms for oral sex. Study Design We used the time–series design to compare condom use and pharyngeal gonorrhea trends before and after program intervention in 1996 and the pretest–posttest matched control group design to determine the impact of brothel interventions on sex workers. Results Consistent oral condom use increased significantly from 42.2% in 1996 to 89.9% in 2000, with a corresponding decline in pharyngeal gonorrhea (in comparison with no significant changes before intervention). Among sex workers in brothels with interventions there was a 10.8% absolute increase in condom use, compared with an 11.7% decrease in condom use in the control group. The gonorrhea incidence rate was also significantly much lower in the intervention group than in the control group (adjusted risk ratio: 0.22; 95% CI: 0.06–0.78). Conclusion The intervention increased oral condom use, with a decline in the incidence of pharyngeal gonorrhea.