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A Randomized Controlled Trial of a Texting Intervention to Maintain Sexual Risk Reduction with Clients Among Female Sex Workers in Tijuana and Ciudad Juarez, Mexico

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Abstract

Mobile phone technology may help sustain reductions in HIV/STI transmission risk behaviors among female sex workers (FSWs). We examined the efficacy of a text messaging intervention designed to maintain behavioral improvements in safer sex practices among 602 FSWs in Tijuana and Ciudad Juarez, Mexico. We hypothesized that FSWs who received brief risk reduction counseling and theory-based safer sex maintenance text messages over a 24-month period would have fewer incident HIV/STIs and report greater maintenance of safer sex practices compared to FSWs who received counseling and texts on maintaining general health. Theory-based texts did not change the odds of becoming infected with HIV/STIs in either study site. However, they did lead to significant, sustained protected sex in Tijuana. Theory-based text messaging interventions may help sustain reductions in sexual risk behavior among FSWs.

Trial Registration Clinical Trials.gov. Identifier: NCT02447484

Resúmen

La tecnología de teléfonos móviles se puede usar para mantener disminuciones en los comportamientos de riesgo de transmisión de VIH/ITS en mujeres trabajadoras sexuales (MTS). Examinamos la eficacia de una intervención con mensajes de texto diseñada para mantener mejoras en comportamiento de prácticas sexuales más seguras en 602 MTS en Tijuana y Ciudad Juárez, México. Propusimos que las MTS que recibieron la consejería breve de reducción del riesgo y los mensajes de texto para mantenimiento de sexo más seguro basado en teoría por un periodo superior a 24 meses tendrían menos incidentes de VIH/ITS e informarían mayor mantenimiento de prácticas de sexo más seguro comparadas con las MTS que recibieron consejería y mensajes de texto sobre mantener una salud general. Los textos basados en teoría no cambiaron la probabilidad de infectarse con VIH/ITS en ninguno de las dos ciudades. Sin embargo, estas dieron lugar a sexo protegido sostenido, significativo en Tijuana. Las intervenciones de mensajes de texto basados en teoría pueden ayudar a mantener disminuciones en comportamientos sexuales de riesgo en MTS.

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Acknowledgements

The authors gratefully acknowledge study staff, participants, and the Municipal and State Health Departments of Tijuana, Baja California, Mexico and Ciudad Juarez, Chihuahua, Salud y Desarrollo Comunitario de Ciudad Juarez and Federación Méxicana de Asociaciones Privadas (SADEC-FEMAP), and Universidad Xochicalco de Tijuana.

Funding

This work was supported by the National Institutes of Health, grants NIH R01 DA039071 (TLP), R37 DA019829 (SAS), R01 DA039071-03S1 (AHV), and R01 DA042666 (EVP).

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Authors and Affiliations

  1. Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, Mail Code 0680, La Jolla, CA, 92093, USA

    Thomas L. Patterson, Shirley J. Semple, Colin Depp & David J. Moore

  2. School of Social Work, San Diego State University, San Diego, CA, USA

    Eileen V. Pitpitan

  3. Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA

    Heather A. Pines, Alicia Harvey-Vera & Steffanie A. Strathdee

  4. Federación Méxicana de Asociaciones Privadas (FEMAP), Ciudad Juarez, Chihuahua, Mexico

    Gustavo Martinez

  5. US-Mexico Border Health Commission, Tijuana, Baja California, Mexico

    M. Gudelia Rangel

Authors
  1. Thomas L. Patterson
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  2. Eileen V. Pitpitan
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  3. Heather A. Pines
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  4. Shirley J. Semple
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  5. Alicia Harvey-Vera
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  6. Colin Depp
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  7. David J. Moore
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  8. Gustavo Martinez
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  10. Steffanie A. Strathdee
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Corresponding author

Correspondence to Thomas L. Patterson.

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The authors declare that they have no conflict of interest.

Ethical Approval

All study procedures were approved by ethics committees at the University of California, San Diego, Xochicalco University in Tijuana, and SADEC-FEMAP in Cd. Juarez. All procedures were conducted in accordance with the 1964 Helsinki Declaration and its later amendments. Written informed consent was obtained from all participants prior to undergoing any study procedures.

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Patterson, T.L., Pitpitan, E.V., Pines, H.A. et al. A Randomized Controlled Trial of a Texting Intervention to Maintain Sexual Risk Reduction with Clients Among Female Sex Workers in Tijuana and Ciudad Juarez, Mexico. AIDS Behav 24, 3306–3319 (2020). https://doi.org/10.1007/s10461-020-02930-1

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  • DOI: https://doi.org/10.1007/s10461-020-02930-1

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