Declines in risk behaviour and sexually transmitted infection prevalence following a community-led HIV preventive intervention among female sex workers in Mysore, India


Reza-Paul, S; Beattie, T; Syed, HUR; Venukumar, KT; Venugopal, MS; Fathima, MP; Raghavendra, HR; Akram, P; Manjula, R; Lakshmi, M; Isac, S; Ramesh, BM; Washington, R; Mahagaonkar, SB; Glynn, JR; Blanchard, JF; Moses, S; (2008) Declines in risk behaviour and sexually transmitted infection prevalence following a community-led HIV preventive intervention among female sex workers in Mysore, India. AIDS (London, England), 22. S91-S100. ISSN 0269-9370 DOI: https://doi.org/10.1097/01.aids.0000343767.08197.18

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Abstract

Objective: To investigate the impact on sexual behaviour and sexually transmitted infections (STI) of a comprehensive community-led intervention programme for reducing sexual risk among female sex workers (FSW) in Mysore, India. The key programme components were: community mobilization and peer-mediated outreach; increasing access to and utilization of sexual health services; and enhancing the enabling environment to support programme activities. Methods: Two cross-sectional surveys among random samples of FSW were conducted 30 months apart, in 2004 and 2006. Results: Of over 1000 women who sell sex in Mysore city, 429 participated in the survey at baseline and 425 at follow-up. The median age was 30 years, median duration in sex work 4 years, and the majority were street based (88%). Striking increases in condom use were seen between baseline and follow-up surveys: condom use at last sex with occasional clients was 65% versus 90%, P < 0001; with repeat clients 53% versus 66%, P < 0.001; and with regular partners 7% versus 30%., P < 0.001. STI prevalence declined from baseline to follow-up: syphilis 25% versus 12%, P < 0.001; trichomonas infection 33% versus 14%, P < 0.001; chlamydial infection 11% versus 5%, P = 0.001; gonorrhoea 50% versus 2%, P = 0.03. HIV prevalence remained stable (26% versus 24%), and detuned assay testing suggested a decline in recent HIV infections. Conclusion: This comprehensive HIV preventive intervention empowering FSW has resulted in striking increases in reported condom use and a concomitant reduction in the prevalence Of Curable STI. This model should be replicated in similar urban settings across India.

Item Type: Article
Keywords: Adolescent, Adult, Condoms, utilization, Epidemiologic Methods, Female, HIV Infections, epidemiology, prevention & control, transmission, Health Promotion, methods, Humans, India, epidemiology, Middle Aged, Program Evaluation, Prostitution, statistics & numerical data, Risk-Taking, Sexual Behavior, statistics & numerical data, Sexually Transmitted Diseases, epidemiology, prevention & control, transmission, Socioeconomic Factors, Unsafe Sex, statistics & numerical data, Young Adult
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre: Social and Mathematical Epidemiology (SaME)
PubMed ID: 19098483
Web of Science ID: 262876700008
URI: http://researchonline.lshtm.ac.uk/id/eprint/5545

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