A Mobile Intervention to Link Young Female Entertainment Workers in Cambodia to Health and Gender-Based Violence Services: Randomized Controlled Trial
Brody C, Chhoun P, Tuot S, Fehrenbacher A, Moran A, Swendeman D, Yi S. A Mobile Intervention to Link Young Female Entertainment Workers in Cambodia to Health and Gender-Based Violence Services: Randomized Controlled Trial. J Med Internet Res 2022;24(1):e27696 DOI: 10.2196/27696
This study evaluated the efficacy of the Mobile Link intervention to improve female entertainment workers’ (FEW) health through engagement and connection to HIV, sexual and reproductive health, and gender-based violence services. In Cambodia, FEWs are employed at karaoke bars, restaurants, bars, and massage parlors and many exchange sex to supplement their income. Researchers conducted a randomized controlled trial in the capital city and 3 other regions in Cambodia with high numbers of FEWs and HIV prevalence. Eligible participants were aged 18-30 years, working as a FEW, sexually active, and owned a mobile phone. Participants were randomized to the Mobile Link intervention arm (n=218) or to the control arm (standard care; n=170). For 60 weeks, participants in the Mobile Link arm received automated twice-weekly text messages and voice messages with health information and direct links to community outreach workers. Outcomes included self-reported HIV and sexually transmitted infection (STI) testing, condom use, and contraceptive use at baseline and 6- and 12-month follow up. Results showed significant improvements in HIV and STI testing, condom use, and contraceptive use in both arms. The Mobile Link intervention was effective in connecting FEWs with outreach workers – contact increased by 61% in the intervention arm compared to a decrease of 30% in the control arm. Additionally, participants in the intervention arm reported significant reductions in forced drinking behavior at work from supervisors or peers compared to those in the control arm. Although there were no differences in the main outcomes, the Mobile Link intervention may be helpful in linking to outreach workers and could be potentially implemented among other populations in Cambodia, perhaps as an adjunct to standard care. Future research may consider using longer-term messaging to increase access to services and impact health outcomes.