Changes in STI prevention knowledge after reproductive health education among female sex workers in Makassar

Female sex workers are considered a key population with increased vulnerability to sexually transmitted infections (STIs) due to biological, behavioral, social, and structural factors. Limited knowledge regarding STI transmission, symptoms, prevention methods, testing, and treatment may reduce their ability to recognize risks and access appropriate health information. Health education targeting STI prevention knowledge may serve as an important component of primary healthcare strategies for vulnerable populations. This study aimed to evaluate changes in STI prevention knowledge scores among female sex workers after participating in a structured reproductive health education program in the service area of Andalas Public Health Center, Makassar. A one-group pretest–posttest design was conducted among female sex workers recruited using non-probability convenience sampling. Participants were recruited between September 20 and October 20, 2024. Of the 66 individuals approached, 10 declined participation, and 56 participants completed both pretest and posttest assessments. Participants received a structured 60-minute reproductive health education session covering STI transmission, symptoms, risk factors, condom-related information, STI/HIV testing, treatment-seeking behavior, and available referral services. The primary outcome was the change in STI prevention knowledge scores measured using a structured 10​​-item questionnaire administered immediately before and after the intervention. Data were analyzed using descriptive statistics and a paired-samples t-test to compare knowledge scores before and after the intervention. Before the intervention, 30 participants (53.6%) had poor knowledge and 26 participants (46.4%) had good knowledge regarding STI prevention. After the intervention, 54 participants (96.4%) were categorized as having good knowledge, while 2 participants (3.6%) remained in the poor knowledge category. The mean knowledge score increased from 6.64 before the intervention to 8.23 after the intervention. Knowledge scores increased significantly after the intervention (mean difference=1.59; 95% CI=0.94–2.24; t(55)=4.87; p<0.001), with a moderate effect size (Cohen’s dz=0.65). Structured reproductive health education was associated with an immediate improvement in STI prevention knowledge scores among female sex workers in Makassar. These findings indicate short-term cognitive improvement following health education. Further studies using controlled designs and longer follow-up periods are required to evaluate long-term knowledge retention.