The Gender-inclusive Sexual Health Literacy Scale for Sex Workers (SHL-SW) is a reliable and valid 10-item instrument for assessing sexual health literacy among sex workers in Thailand, demonstrating high internal consistency and a confirmed four-factor structure.
The final SHL-SW demonstrated high internal consistency with a Cronbach's alpha of 0.92.
Confirmatory factor analysis confirmed a four-factor structure with excellent model fit indices.
The SHL-SW was developed through a three-stage mixed methods approach involving literature review, expert consultation, and questionnaire validation.
The SHL-SW is described as the first instrument specifically validated for gender inclusivity among sex workers.
The SHL-SW is intended to enable identification of sexual health literacy gaps and support design of rights-based interventions and evidence-based policies.
This research describes the development and testing of a new survey tool called the Sexual Health Literacy Scale for Sex Workers (SHL-SW), designed to measure how well sex workers can find, understand, evaluate, and use sexual health information. The tool was created in Thailand using a step-by-step process that included reviewing existing research, consulting 18 experts using a structured method called the Delphi technique, and then testing the final 10-question survey with 600 sex workers. The survey was specifically designed to be inclusive of people of all gender identities within the sex worker community. The testing showed that the tool performs very well statistically. It had high internal consistency (meaning the questions reliably measure the same underlying concept), and statistical analysis confirmed that the questions group into four meaningful categories: accessing sexual health information, understanding it, critically evaluating it, and applying it in real life. All measures of how well the statistical model fit the data were within excellent ranges. This research suggests that before this tool existed, there was no validated, gender-inclusive way to measure sexual health literacy specifically in sex worker populations. Having such a tool matters because it allows researchers and public health workers to identify where gaps in sexual health knowledge and skills exist among sex workers, which in turn can guide the design of more effective and rights-focused health programs and policies aimed at reducing health inequalities for this marginalized group.
Thongnopakun S, Magteppong W, Visanuyothin S, Charoenying J, Thongnoppakun O, Ketkrongkuay P, et al.. (2026). Gender-inclusive sexual health literacy scale for sex workers (SHL-SW): Development and validation in Thailand.. PloS one. https://doi.org/10.1371/journal.pone.0341345