Adapting the Thai 100% condom programme: Developing a culturally appropriate model for the Dominican Republic

The reported success of the Thai 100% Condom Programme prompted interest in adapting such an approach to HIV prevention in the Dominican Republic. Qualitative research methods were utilized to examine the acceptability and feasibility of doing so, as well as to investigate socio-cultural and political issues affecting condom use in the Dominican female sex industry. Study participants included female sex workers, male paying clients and non-paying steady partners of sex workers, sex establishment owners/administrators and governmental and nongovernmental public health workers and officials. Study results revealed support on the part of participants for policies and rules to promote and monitor the use of condoms within sex establishments. Owners/administrators reported that having a '100% condom use' establishment could increase business by making clients feel safer and thus more likely to visit an ‘STD free’ environment. One of the most important barriers to condom use was the development of trust and intimacy between sex workers and their regular paying and non-paying partners. A modified version of the Thai 100% condom programme was developed specifically for the Dominican context and is currently being implemented and evaluated.