title: Promoting condoms for oral sex: impact on pharyngeal gonorrhea among female brothel-based sex workers.
abstract: BACKGROUND
  Low condom use for oral sex among female brothel-based sex workers in Singapore has led to a rise in pharyngeal gonorrhea.
  
  
  OBJECTIVE
  The goal of the study was to evaluate a program promoting the use of condoms for oral sex.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  The intervention increased oral condom use, with a decline in the incidence of pharyngeal gonorrhea.
authors.affiliation: Department of Community, Occupational, and Family Medicine (MD 3), Faculty of Medicine, National University of Singapore, Singapore. cofwml@nus.edu.sg
authors.forename: Mee Lian
authors.initials: ML
authors.lastname: Wong
authors.forename: Roy K W
authors.initials: RK
authors.lastname: Chan
authors.forename: David
authors.initials: D
authors.lastname: Koh
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000517:prevention & control*; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D010608:Pharyngeal Diseases / Q000453:epidemiology / Q000517:prevention & control*; D015397:Program Evaluation; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D021841:Safe Sex; D011477:Sex Work / Q000706:statistics & numerical data; D012846:Singapore / Q000453:epidemiology