Community Mobilization and Empowerment of Female Sex Workers in Karnataka State, South India: Associations With HIV and Sexually Transmitted Infection Risk.


Beattie, TS; Mohan, HL; Bhattacharjee, P; Chandrashekar, S; Isac, S; Wheeler, T; Prakash, R; Ramesh, BM; Blanchard, JF; Heise, L; Vickerman, P; Moses, S; Watts, C; (2014) Community Mobilization and Empowerment of Female Sex Workers in Karnataka State, South India: Associations With HIV and Sexually Transmitted Infection Risk. American journal of public health, 104 (8). pp. 1516-25. ISSN 0090-0036 DOI: https://doi.org/10.2105/AJPH.2014.301911

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Abstract

OBJECTIVES: We examined the impact of community mobilization (CM) on the empowerment, risk behaviors, and prevalence of HIV and sexually transmitted infection in female sex workers (FSWs) in Karnataka, India.<br/> METHODS: We conducted behavioral-biological surveys in 2008 and 2011 in 4 districts of Karnataka, India. We defined exposure to CM as low, medium (attended nongovernmental organization meeting or drop-in centre), or high (member of collective or peer group). We used regression analyses to explore whether exposure to CM was associated with the preceding outcomes. Pathway analyses explored the degree to which effects could be attributable to CM.<br/> RESULTS: By the final survey, FSWs with high CM exposure were more likely to have been tested for HIV (adjusted odd ratio [AOR] = 25.13; 95% confidence interval [CI] = 13.07, 48.34) and to have used a condom at last sex with occasional clients (AOR = 4.74; 95% CI =  2.17, 10.37), repeat clients (AOR = 4.29; 95% CI = 2.24, 8.20), and regular partners (AOR = 2.80; 95% CI = 1.43, 5.45) than FSWs with low CM exposure. They were also less likely to be infected with gonorrhea or chlamydia (AOR = 0.53; 95% CI = 0.31, 0.87). Pathway analyses suggested CM acted above and beyond peer education; reduction in gonorrhea or chlamydia was attributable to CM.<br/> CONCLUSIONS: CM is a central part of HIV prevention programming among FSWs, empowering them to better negotiate condom use and access services, as well as address other concerns in their lives.<br/>

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre: Gender Violence and Health Centre
Social and Mathematical Epidemiology (SaME)
SaME Modelling & Economics
STRIVE
Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 24922143
Web of Science ID: 341811000050
URI: http://researchonline.lshtm.ac.uk/id/eprint/1783011

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