Chi Chiao, MSc, MSPH, Department of Community Health Sciences, UCLA School of Public Health, Box 951772, Los Angeles, CA 90095-1772, 310-794-9889, cchiao@ucla.edu

Background: Since STI is a co-factor of HIV/AIDS, a routine sexual health check-up for female sex workers (FSWs) is considered to be a crucial health preventive behavior for detecting STIs at early stage and reducing the risk of contracting HIV.

Objectives: This study explores the social and structural determinants of medical appointment-keeping adherence for FSWs in the Philippines. Specifically, we examine the relative impact of individual demographic, socioeconomic, family characteristics and establishment traits on the likelihood of FSWs’ missed scheduled appointments using a multilevel analytical approach.

Methods: Multiple sources of information were used, including data from the medical records, face-to-face interviews of FSWs and their managers, respectively, and a contextual data recorded from outreach workers. Results: By calculating intra-class correlation, 60% of the variance of the compliance rate occurred between establishments (p<.0001). Controlling for the individual-level factors, we also found establishment history and condom use policy are most significant predictors of adherence to medical appointments for FSWs. For the establishment with a condom use policy, the average compliance rates are 12.8% higher on the compliance measure (p<.05) compared to establishments without a policy. For each year of workplace history, the average compliance rate of the establishment increases by 1.4% (p<.05). Conclusions: The findings indicate that establishment background is an important determinant of adherences to kept medical appointments for FSWs, even in the presence of controls for a large number of observed characteristics of individuals, families, and workplaces. Implications for interventions aimed at increasing medical adherence will be discussed.

Learning Objectives:

• Acquire knowledge about multilevel analytical approach. 2)Describe the relationship between adherence to medical appointment and individual-level and establishment-level characteristics of female sex workers in the Philippines. 3)Discuss the potential interventions and policy implications and adherence to medical appointments to STIs and HIV/AIDS epidemics.

Keywords: Sex Workers, STD

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.