A pilot study, auditing digital communication to conduct sexual and reproductive health service outreach to Chinese- and Thai-speaking sex workers in Sydney
Katherine Coote
A * , Maggie Ma A , Birdie Thirapat A , Limin Mao B and Rick Varma A
A
B
Abstract
A large sexual health service (SHS) in Sydney has piloted the use of Mandarin-language app ‘WeChat’ and Thai-language app ‘LINE’, to enhance outreach to Chinese- and Thai-speaking sex industry workers (SIWs). These platforms offer a novel and unique means for Thai and Chinese SIWs to access the SHS, bypassing potential lengthy wait times otherwise experienced through phone triage, using telephone interpreters.
From 5 February to 5 April 2024, data from clients’ posts on both platforms were extracted and dissected according to the following indices: current registration with the SHS, approximate time taken for response to messages, demographic client information, and key service/s requested.
During the 2-month data extraction period, the total subscription to the online platforms was 329, comprising 227 (69%) posts on WeChat and 102 (31%) on LINE. New clients made up about one-third of the overall clientele on both platforms. Overall, an estimated average of 10 min was the most common (the mode) length of time taken to respond to clients’ online posts. The two most frequently requested services were to introduce relevant sexual reproductive health services and to book clinical appointments.
This pilot provided valuable information about how the SHS WeChat and LINE platforms are used by their target populations. This information has informed the development of resources to enhance efficient administration of these platforms. The data may also be used to help justify the continued use of these platforms to reach these at-risk priority populations, despite wider security concerns about foreign-owned platforms, such as WeChat.
Keywords: health education, in-language, LINE, outreach, priority populations, sex workers, sexual health, social media, WeChat.
References
1 Gomez GB, Campos PE, Buendia C, Carcamo CP, Garcia PJ, Segura P, Whittington WL, Hughes JP, Ward H, Garnett GP, Holmes KK. Studying complex interactions among determinants of healthcare-seeking behaviours: self-medication for sexually transmitted infection symptoms in female sex workers. Sex Transm Infect 2010; 86(4): 285-291.
| Crossref | Google Scholar | PubMed |
2 Hong H, Xu GZ, Zhang DD. HIV risk, drug use, and sexual transmission among female sex workers in Ningbo, China. Int J Gynaecol Obstet 2013; 121: 91-92.
| Crossref | Google Scholar | PubMed |
3 Ngo AD, Ratliff EA, McCurdy SA, Ross MW, Markham C, Pham HTB. Health-seeking behaviour for sexually transmitted infections and HIV testing among female sex workers in Vietnam. AIDS Care 2007; 19: 878-887.
| Crossref | Google Scholar |
4 World Population Review. WeChat users by country 2025. 2025. Available at https://worldpopulationreview.com/country-rankings/wechat-users-by-country
5 Zhang L, Jung EH. How does WeChat’s active engagement with health information contribute to psychological well-being through social capital? Univers Access Inf Soc 2021; 21(3): 657-673.
| Crossref | Google Scholar |
6 Lin Y, Ren C, Liao M, Kang D, Li C, Jiao K, Wang L, Yan Y, Li Y, Wu T, Cheng C, Zhao Z, Xu Z, Tang W, Tucker JD, Ma W. Digital, crowdsourced, multilevel intervention to promote HIV testing among men who have sex with men: cluster randomized controlled trial. J Med Internet Res 2023; 25: e46890.
| Crossref | Google Scholar |
7 Zhang Y, Tang S, Li K, et al. Quantitative evaluation of an innovation contest to enhance a sexual health campaign in China. BMC Infect Dis 2019; 19: 112.
| Crossref | Google Scholar | PubMed |
8 Zhu X, Zhang W, Operario D, et al. Effects of a mobile health intervention to promote HIV self-testing with MSM in China: a randomized controlled trial. AIDS Behav 2019; 23(11): 3129-3139.
| Crossref | Google Scholar | PubMed |
9 Zhao Y, Zhu X, Pérez AE, et al. MHealth approach to promote oral HIV self-testing among men who have sex with men in China: a qualitative description. BMC Public Health 2018; 18(1): 1146.
| Crossref | Google Scholar | PubMed |
10 Parliament of Australia. Senate select committee on foreign interference through social media, report August 2023. Parliament of Australia; 2023. Available at https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Foreign_Interference_through_Social_Media/ForeignInterference47/Report
