Abstract
Diffusion of innovation (DOI) is widely cited in the HIV behavior change literature; however there is a dearth of research
on the application of DOI in interventions for sex workers. Following a randomized-controlled trial of HIV risk reduction
among female entertainment workers (FEWs) in Shanghai, China, we used qualitative approaches to delineate potential interpersonal
communication networks and contributing factors that promote diffusion of information in entertainment venues. Results showed
that top-down communication networks from the venue owners to the FEWs were efficient for diffusion of information. Mammies/madams,
who act as intermediaries between FEWs and clients form an essential part of FEWs’ social networks but do not function as
information disseminators due to a conflict of interest between safer sex and maximizing profits. Diffusion of information
in large venues tended to rely more on aspects of the physical environment to create intimacy and on pressure from managers
to stimulate communication. In small venues, communication and conversations occurred more spontaneously among FEWs. Information
about safer sex appeared to be more easily disseminated when the message and the approach used to convey information could
be tailored to people working at different levels in the venues. Results suggest that safer sex messages should be provided
consistently following an intervention to further promote intervention diffusion, and health-related employer liability systems
in entertainment venues should be established, in which employers are responsible for the health of their employees. Our study
suggests that existing personal networks can be used to disseminate information in entertainment venues and one should be
mindful about the context-specific interactions between FEWs and others in their social networks to better achieve diffusion
of interventions.
on the application of DOI in interventions for sex workers. Following a randomized-controlled trial of HIV risk reduction
among female entertainment workers (FEWs) in Shanghai, China, we used qualitative approaches to delineate potential interpersonal
communication networks and contributing factors that promote diffusion of information in entertainment venues. Results showed
that top-down communication networks from the venue owners to the FEWs were efficient for diffusion of information. Mammies/madams,
who act as intermediaries between FEWs and clients form an essential part of FEWs’ social networks but do not function as
information disseminators due to a conflict of interest between safer sex and maximizing profits. Diffusion of information
in large venues tended to rely more on aspects of the physical environment to create intimacy and on pressure from managers
to stimulate communication. In small venues, communication and conversations occurred more spontaneously among FEWs. Information
about safer sex appeared to be more easily disseminated when the message and the approach used to convey information could
be tailored to people working at different levels in the venues. Results suggest that safer sex messages should be provided
consistently following an intervention to further promote intervention diffusion, and health-related employer liability systems
in entertainment venues should be established, in which employers are responsible for the health of their employees. Our study
suggests that existing personal networks can be used to disseminate information in entertainment venues and one should be
mindful about the context-specific interactions between FEWs and others in their social networks to better achieve diffusion
of interventions.
- Content Type Journal Article
- Category Original Paper
- Pages 1-11
- DOI 10.1007/s10461-012-0214-1
- Authors
- Yiyun Chen, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA
- Carl Latkin, Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- David D. Celentano, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Xiushi Yang, Department of Sociology and Criminal Justice, Old Dominion University, Norfolk, VA, USA
- Xiaoming Li, Pediatric Prevention Research Center, Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA
- Guomei Xia, Center for HIV/AIDS Social Policies, Shanghai Academy of Social Sciences, Shanghai, China
- Jia Miao, Center for HIV/AIDS Social Policies, Shanghai Academy of Social Sciences, Shanghai, China
- Pamela J. Surkan, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA
- Journal AIDS and Behavior
- Online ISSN 1573-3254
- Print ISSN 1090-7165