BACKGROUND: In 2003 a large-scale HIV prevention program was launched for key populations in six high HIV prevalence states of India. This paper assesses the effect of exposure to the intervention on condom use with commercial clients and experiences of sexually transmitted infection (STI) among female sex workers (FSWs) in Tamilnadu, a southern Indian state, between 2006 and 2009. METHODS: Data were drawn from two rounds of cross-sectional surveys conducted in 2006 (N = 2010) and 2009 (N = 2500) among FSWs in Tamilnadu, recruited through probability-based sampling. A series of multivariate logistic regression models were constructed to examine the association between exposure to the intervention and change over time with condom use and self-reported STI. All the analyses were performed using STATA 11.1. RESULTS: Overall, 48% of FSWs in 2006 and 90% in 2009 reported exposure to the intervention. Compared to 2006, there was a considerable increase in the proportion of FSWs reporting consistent condom use with regular and occasional clients at follow-up (2009). Further, the increase in consistent condom use over time with occasional (adjusted OR = 3.53, 95% CI: 2.47 - 5.05) and regular clients (adjusted OR = 4.97, 95% CI: 3.43 - 7.16) was significantly higher among FSWs exposed to the intervention than those not exposed. Additionally, a significant decline was observed in self-reported STI overtime among FSWs exposed to the intervention compared to their counterparts (adjusted OR = 0.39, 95% CI: 0.26 - 0.59). CONCLUSION: The HIV prevention program in Tamilnadu resulted in increased consistent condom use and a decrease in self-reported STI among FSWs exposed to intervention. These findings suggest that HIV prevention programs should aim to saturate coverage among key populations to sustain the gains achieved.
BACKGROUND: In 2003 a large-scale HIV prevention program was launched for key populations in six high HIV prevalence states of India. This paper assesses the effect of exposure to the intervention on condom use with commercial clients and experiences of sexually transmitted infection (STI) among female sex workers (FSWs) in Tamilnadu, a southern Indian state, between 2006 and 2009. METHODS: Data were drawn from two rounds of cross-sectional surveys conducted in 2006 (N = 2010) and 2009 (N = 2500) among FSWs in Tamilnadu, recruited through probability-based sampling. A series of multivariate logistic regression models were constructed to examine the association between exposure to the intervention and change over time with condom use and self-reported STI. All the analyses were performed using STATA 11.1. RESULTS: Overall, 48% of FSWs in 2006 and 90% in 2009 reported exposure to the intervention. Compared to 2006, there was a considerable increase in the proportion of FSWs reporting consistent condom use with regular and occasional clients at follow-up (2009). Further, the increase in consistent condom use over time with occasional (adjusted OR = 3.53, 95% CI: 2.47 - 5.05) and regular clients (adjusted OR = 4.97, 95% CI: 3.43 - 7.16) was significantly higher among FSWs exposed to the intervention than those not exposed. Additionally, a significant decline was observed in self-reported STI overtime among FSWs exposed to the intervention compared to their counterparts (adjusted OR = 0.39, 95% CI: 0.26 - 0.59). CONCLUSION: The HIV prevention program in Tamilnadu resulted in increased consistent condom use and a decrease in self-reported STI among FSWs exposed to intervention. These findings suggest that HIV prevention programs should aim to saturate coverage among key populations to sustain the gains achieved.
Authors: Michael Pickles; Marie-Claude Boily; Peter Vickerman; Catherine M Lowndes; Stephen Moses; James F Blanchard; Kathleen N Deering; Janet Bradley; Banadakoppa M Ramesh; Reynold Washington; Rajatashuvra Adhikary; Mandar Mainkar; Ramesh S Paranjape; Michel Alary Journal: Lancet Glob Health Date: 2013-09-30 Impact factor: 26.763
Authors: Sushena Reza-Paul; Rob Lorway; Nadia O'Brien; Lisa Lazarus; Jinendra Jain; M Bhagya; P Fathima Mary; K T Venukumar; K N Raviprakash; James Baer; Richard Steen Journal: Indian J Med Res Date: 2012 Impact factor: 2.375
Authors: Hari Kumar Rachakulla; Venkaiah Kodavalla; Hemalatha Rajkumar; S P V Prasad; Srinivasan Kallam; Prabuddhagopal Goswami; Jayesh Dale; Rajatashuvra Adhikary; Ramesh Paranjape; G N V Brahmam Journal: BMC Public Health Date: 2011-12-29 Impact factor: 3.295
Authors: Rakhi Dandona; Lalit Dandona; Juan Pablo Gutierrez; Anil G Kumar; Sam McPherson; Fiona Samuels; Stefano M Bertozzi Journal: BMC Public Health Date: 2005-08-20 Impact factor: 3.295