1. HIV Prevention & Health Promotion for Asian Women Working at Massage Parlors in San Francisco Health Project for Asian Women (HPAW) Center for AIDS Prevention Studies (CAPS) University of California, San Francisco (UCSF)

2. Objectives  To describe drug use and HIV-related risk behaviors among Asian masseuses at Asian massage parlors in San Francisco  To provide women’s health and HIV/AIDS education to masseuses as well as owners/managers of parlors  To implement and evaluate the intervention programs for masseuses and owners/managers to increase masseuses’ protective behaviors against HIV/STIs and drug abuse

3. Background Asian Massage Parlors in San Francisco  Identified 25 Massage parlors where masseuses exchanged sex for money in the Tenderloin area 12 Vietnamese Owned 10 Korean Owned 3 Chinese Owned

4. Background Asian Masseuses in San Francisco  Underserved population  Immigrants  Monolingual  Harmful practices to women’s heath  Multiple sex partners  Lack of access to health care services  Inconsistent condom use with clients and private partners  Substance use due to highly stressful job

5. HPAW is……  Service Component Daily outreach activities  Research Component HIV/AIDS and Drug abuse intervention study  Masseuse’s Counseling Program  Owner’s Education Program

6. Outreach Effort  Clinic escort  Safer sex kits distribution  Health education  Translation  Referral services  Advocating

7. Outreach Efforts - Challenges  Highly mobilized population  Stigmatized population  Owners/Managers acceptance  Demographic changes in business

8. Outreach Efforts - Challenges  Frequent disruptions by customers  Unfamiliarity with research  Law enforcement  Limited English proficiency

9. Outreach Effort – Lesson & Learned  Consistent outreach  Clinic escorts  Safer sex kits distribution  Respect toward massage parlor business

10. Outreach Effort – Lesson & Learned  Recruitment through masseuses’ referrals  Flexibility  Confrontation

11. Intervention Programs

12. Counseling Program  1st Session ObjectivesProceduresOutcomes Assess & prioritize needs Needs Assessment  Health Status  Social Network  Services Utilization  Family Issues Measure baseline attitudes toward health and well-being

13. Counseling Program  2 nd Session ObjectivesProceduresOutcomes Increase knowledge about general women’s health & STDs/HIV Informative session  Douching  Women’s health  Birth control method  Symptoms of HIV/STDs  Challenges for safe sex Referrals/ Resources Increase women’s health & HIV/STDs knowledge Increase knowledge & use of cultural sensitive CBOs

14. Counseling Program  3 rd Session ObjectivesProcedures Outcomes Increase psycho- social skills Discussion  Stress Reduction  Social Skills  Other concerns Referrals/ Resources Increase positive coping strategies Higher self-esteem Enhance sense of control toward stress Higher level of adjustment to living in US Increase knowledge & use of cultural sensitive CBOs

15. HPAW Staff  Principal Investigator: Tooru Nemoto, Ph.D.  Project Director: Mariko Iwamoto, M.A.  Project Assistant: Samantha Witt  Health Educators: Ha Chu Yon-Hee Kim Yoonjung Kim Phuong Ngo

16. Thank you! supported by the National Institute on Drug Abuse (NIDA) Grant No: R01DA13896