SPECIFIC AIMS: The proposed study will describe drug use and HIV-related behaviors among Asian female commercial sex workers at massage parlors (Asian masseuses) in San Francisco. The study will also conduct an intervention and evaluate the efficacy of two intervention modalities: One which targets the environmental level (Massage Parlor Owner Education Program) and one which targets the individual level (Peer/Professional Counseling Program). Through this intervention study, the determinants of HIV-related risk and protective behaviors among the targeted Thai and Vietnamese masseuses will be identified. The study will be conducted through the collaboration with the Asian and Pacific Islander Wellness Center (APIWC), which has been providing AIDS prevention programs to the target groups. The objectives of the study are: 1) To describe drug use and HIV- related behaviors among Asian masseuses at massage parlors, where risk and urgent needs for interventions are evident but research has thus far been limited, 2) To examine the working conceptual model for the intervention, which is specific to masseuses' gender, culture, and occupation, 3) To develop and evaluate the intervention programs, in which the constructs of the conceptual model will be addressed at both individual and environmental levels to increase masseuses' protective behaviors against drug abuse, HIV/STD infection, and violence, and 4) To disseminate the study findings through local and national networks among AIDS service organizations (ASOs) and Asian American ethnic organizations and in professional journals. METHODS: The study has three stages: 1) Preparation of the study, including staff training, mapping, focus groups, and a pilot study, 2) Conducting the intervention study, and 3) Data analyses and dissemination of the study findings. Eight focus groups (2 for each group: Thai masseuses; Vietnamese masseuses; massage parlor owners; customers) will be conducted to identify and describe drug use and HIV-related behaviors at massage parlors. Based on the focus groups, mapping, and a pilot intervention study (2 owners and 24 masseuses), the intervention study will be finalized. The study will evaluate the efficacy of the intervention based on a 2 (Owner Education vs. Control) by 3 (Peer Counseling vs. Professional Counseling vs. Control), by 2 (Thai vs. Vietnamese) longitudinal design (pre-, post-, and follow-up tests). A total of 12 owners, and 96 Thai and 96 Vietnamese masseuses will be randomly assigned to the conditions. The specific hypotheses and conceptual model will be tested by qualitative as well as quantitative analyses. SIGNIFICANCE: This will be the first HIV prevention intervention study targeting Asian commercial sex workers at massage parlors in the U.S. Asian masseuses are hard to reach and have been neglected by HIV/AIDS and drug abuse prevention efforts and health care systems. The study will assess the impact of drug abuse and HIV/STDs among the targeted and affected populations in the community, promote protective work environment through massage parlor owners, promote protective behaviors among masseuses, and contribute to HIV prevention theories through incorporating the constructs of gender, culture, and occupation.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Special Emphasis Panel (ZRG1-AARR-8 (01))
Program Officer
Hartsock, Peter
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Nemoto, Tooru; Iwamoto, Mariko; Sakata, Maria et al. (2013) Social and cultural contexts of HIV risk behaviors among Thai female sex workers in Bangkok, Thailand. AIDS Care 25:613-8
Nemoto, Tooru; Iwamoto, Mariko; Colby, Donn et al. (2008) HIV-related risk behaviors among female sex workers in Ho Chi Minh City, Vietnam. AIDS Educ Prev 20:435-53
Nemoto, Tooru; Iwamoto, Mariko; Wong, Serena et al. (2004) Social factors related to risk for violence and sexually transmitted infections/HIV among Asian massage parlor workers in San Francisco. AIDS Behav 8:475-83