Knowledge and Preventive Practices Toward COVID-19 Among Sex Workers in Chiang Mai, Thailand

Sex workers were disproportionately affected by the COVID-19 pandemic due to precarious working conditions. This cross-sectional study was conducted in 2022 among 264 sex workers in Chiang Mai, Thailand, during the transition to the endemic phase, to evaluate their COVID-19 knowledge and preventive practices. Face-to-face interviews were used. Descriptive statistics were used to describe sample characteristics. Factors associated with knowledge and preventive practices were identified using the Mann–Whitney U test or Kruskal–Wallis test as appropriate. Independent factors associated with preventive practices were assessed through linear regression. The median scores for knowledge and preventive practices were 10 (interquartile range (IQR) = 9–10) and 5 (IQR = 3–5), respectively. In univariate analysis, females scored higher in knowledge than males. For preventive practices, females vs. males, older vs. younger, heterosexual vs. homosexual/bisexual, longer vs. shorter career, worked in massage parlors vs. pubs/bars, and having child vs. none showed higher rates. In multivariate analysis, being male (β = −1.87; 95%CI; −0.87 to −0.88) and single (β = −1.15; 95%CI; −2.28 to −0.02) were independent predictors of lower rates of preventive practices. Despite having good knowledge, certain groups of sex workers’ COVID-19 preventive behaviors remain inadequate, emphasizing the need for targeted interventions to enhance pandemic preparedness.