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

The COVID–19 pandemic disproportionately affected marginalized groups, including sex workers, who faced heightened risks due to precarious work environments. This cross–sectional study, conducted from March to October 2022 in Chiang Mai, Thailand, assessed COVID–19 knowledge and preventive measures among 264 sex workers to guide public health strategies and reduce transmission. Structured questionnaires were used, and knowledge and practice scores were classified as good or poor on the basis of an 80% threshold. The data were analysed via descriptive and inferential statistics. The median knowledge score was 10 (IQR = 9–10), with 89% (n = 235) demonstrating strong awareness. However, preventive practices were weaker (median = 5, IQR = 3–5), with only 32.2% (n = 85) exhibiting good adherence. Females outperformed males (p < 0.001), whereas older individuals followed preventive measures more consistently (p < 0.001). The heterosexual participants scored highest (p < 0.001), and those with 5.1–10 years of experience showed better compliance (p = 0.033). A weak but significant correlation was observed between knowledge and practice (ρ = 0.218, p < 0.001). Despite strong awareness, preventive behaviors remain inadequate, emphasizing the need for targeted interventions to enhance disease prevention and pandemic preparedness.