Using Formative Research to Promote Behavior Change among Male Clients of Female Sex Workers in Vietnam

Created as part of a larger HIV prevention project, the campaign described here was developed to reduce new HIV infections among the most-at-risk-populations in Vietnam – sex workers and their male clients, injecting drug users, and men having sex with men. Implemented in two phases, phase one of this campaign focused on raising awareness and self efficacy among the target audience. The three main objectives identified during this phase were to (1) increase risk perception for HIV linked to sex with a sex worker, (2) increase ability to understand one’s limits with regards to risky sexual behavior, and (3) develop a personal prevention strategy. To tackle these objectives, a mass media campaign was launched under an umbrella brand, Vui Co Chung, Dung Dung Luc (Know When to Play, Know When to Stop) and reached the target audience through television ads, newspapers, billboards, bus stops, and web-based media. Before launching phase two of the campaign, research was conducted to gain a deeper understanding of the target audience and their motivations to engage in certain behaviors. Data was gathered through an in-person questionnaire that was administered to 645 males aged 18-40 who had visited sex workers in the last three months and were residents of either Hanoi or Ho Chi Minh City. Additionally, 24 in-depth interviews were conducted with males fitting this demographic to further explore their decision-making process around sex and condom use with sex workers. This research resulted in the creation of ‘Tuan’, a character whose profile represented members of the target audience. “Hot spots” which included locations such as hotels, cafes, restaurants, massage parlors, and karaoke bars were identified and used to reach members of the target audience during phase two of the campaign. In this phase, the project team expanded their outreach strategies to include small group and one-on-one activities, larger group activities, and public events, all of which were hosted at entertainment establishments labeled as hot spots. Efforts were also made to increase condom availability at these locations in order to encourage consistent condom use. Two years after the campaign launched, a large-scale quantitative survey was conducted with 1,602 male clients from seven different provinces where the outreach intervention had been implemented. 71% of respondents reported having seen campaign materials. Of those respondents, individuals reported higher risk perceptions and were significantly more likely to have used a condom consistently when engaging with a sex worker compared to individuals not exposed to campaign materials. 
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