title: Evaluating the effectiveness of personal resilience and enrichment programme (PREP) for HIV prevention among female sex workers: a randomised controlled trial.
abstract: BACKGROUND
  Female sex workers (FSWs) are often considered as the vector, if not reservoir, of HIV and other sexually transmitted infections. Building upon the existing evidence on the role of psychological health in sexual health, the aim of this protocol is to describe a trial investigating the effectiveness of the Personal Resilience and Enrichment Programme (PREP), a resilience-promoting intervention that targets at psychological well-being i.e. self-esteem, self-efficacy and coping, to facilitate adaptation and ultimately safe sexual practices among FSWs, which could be an innovative strategy in controlling the spread of these infections.
  
  
  METHODS
  A total of 132 FSWs will be recruited and randomly assigned to either the intervention or usual care (control) groups in a multi-centred randomised controlled trial. Based on the resilience framework, this intervention is comprised of six weekly sessions focused on the awareness, expression and management of emotions, identifying roles and personal strengths, and effective problem-solving skills. Complex intervention assessment on both intervention process and effectiveness will be adopted when the primary outcome reduction of sexual risk behaviour and other psychological outcomes include their perceived stress, self-esteem, self-efficacy, coping overall resilience, and psychological distress will be measured at baseline, post-treatment and 3-month post-intervention and differences assessed by ANOVA. The relationship of resilience factors, psychological health and HIV preventive behaviours will be evaluated using structural equation modelling.
  
  
  CONCLUSIONS
  It is anticipated that this study will increase our understanding of the relationships between individual resilience attributes, positive adaptation, psychological health and sexual health practices. If successful, this programme will provide an innovative direction for HIV prevention by applying the personal resilience factors to promote both psychological well-being and safe sex for this high risk population.
  
  
  BACKGROUND
  ChiCTR-PRC-13003091.
authors.affiliation: Department of Family Medicine & Primary Care, 3/F., Ap Lei Chau Clinic, The University of Hong Kong, 161 Main Street, Ap Lei Chau, Hong Kong, China. winnie.yuen@hku.hk
authors.forename: Winnie Wing-Yan
authors.initials: WW
authors.lastname: Yuen
authors.forename: William Chi-Wai
authors.initials: WC
authors.lastname: Wong
authors.forename: Catherine So-Kum
authors.initials: CS
authors.lastname: Tang
authors.forename: Eleanor
authors.initials: E
authors.lastname: Holroyd
authors.forename: Agnes Fung-Yee
authors.initials: AF
authors.lastname: Tiwari
authors.forename: Daniel Yee-Tak
authors.initials: DY
authors.lastname: Fong
authors.forename: Weng Yee
authors.initials: WY
authors.lastname: Chin
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001294:Attitude to Health; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006723:Hong Kong; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D015397:Program Evaluation; D055500:Resilience, Psychological; D012649:Self Concept; D020377:Self Efficacy; D060386:Sex Workers / Q000523:psychology*; D055815:Young Adult