Community mobilisation programme for female sex workers in coastal Andhra Pradesh, India: processes and their effects

Chakravarthy, J B R; Joseph, Shaju V; Pelto, Pertti J.; Kovvali, Dolly

doi:10.1136/jech-2011-200487

Cited by 23 publications

(14 citation statements)

References 19 publications

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“…This demonstrated relationship between collectivisation, collective efficacy and the indicators of self-efficacy, and confidence gains importance given that FSWs are highly mobile and face multiple vulnerabilities associated with duration of sex work and educational background in cities like Mumbai and Thane 19. Importantly, findings from the current study underline the importance of collective efficacy as strategy to promote HIV prevention interventions, especially in challenging settings as evidenced in the Aastha project and elsewhere 22 23. These results parallel the previous research findings in Karnataka where it was shown that a higher degree of collectivisation was associated with increased knowledge and condom use by FSWs,5 and in Andhra Pradesh, where it was evident that higher degree of community mobilisation increased condom use and reduce violence 1 22…”

Section: Discussionmentioning

confidence: 55%

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How effective is community mobilisation in HIV prevention among highly diverse sex workers in urban settings? The Aastha intervention experience in Mumbai and Thane districts, India

Gaikwad¹,

Bhende²,

Nidhi³

et al. 2012

J Epidemiol Community Health

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Background This paper examines the association between degree of confidence in collective efficacy and self-efficacy for condom use and empowerment among heterogeneous female sex workers (FSWs) in two metropolitan Indian cities with high HIV prevalence. Methods The study utilises data from the Behavioural Tracking Survey, a cross-sectional behavioural study with 2106 FSWs recruited from 411 intervention sites in Mumbai and Thane. The key independent measures used determine the degree of confidence in collective efficacy (belief in the power to achieve goals and address problems together) and outcome measures included: self-efficacy for condom use with occasional clients and condom use with regular partners, self-confidence in handling a crisis situation and public speaking ability. Univariate and multivariate statistical methods were used to examine the study objectives.Results Of the analytical sample of 2106 FSWs, 532 (25.3%) reported high degree of collective efficacy for achieving certain goals and 1534 (72.8%) reported collective efficacy for addressing specific problems. FSWs reporting a higher collective efficacy as compared with those reporting lower collective efficacy were as follows: more likely to negotiate condom use with occasional clients (60.3% vs 19.7%; adjusted OR (AOR) ¼6.3, 95% CI 4.8 to 8.4) as well as regular partners (62.8% vs 20.2%; AOR ¼6.4, 95% CI 4.9 to 8.4); confident in facing troublesome stakeholders (73.5% vs 38.8%; AOR ¼4.3, 95% CI 3.3 to 5.6), confident in supporting fellow FSWs in a crisis (76.1% vs 49.6%; AOR ¼2.9, 95% CI 2.2 to 3.7), received help from other FSWs when a client or partner was violent (73.9% vs 46.3%; AOR ¼3.5, 95% CI 2.7 to 4.5) and had stood up to the police or madams/brokers to help fellow FSWs in the past 1 year (5.8% vs 3.3%; AOR ¼2.7, 95% CI 1.5 to 4.9). Conclusion The results suggest that the strategy of collectivisation in HIV prevention programme has much broader benefits than merely the promotion of safer sex practices. Future HIV prevention interventions in India and elsewhere may include collectivisation as the core strategy within HIV prevention programmes.

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Section: Discussionmentioning

confidence: 55%

“…All the researchers had a bachelor's degree in either sociology or statistics. The survey instrument commonly developed by Avahan for its sites in India1 17 22 23 was modified locally to add a few questions that are relevant to the local context. The survey instrument was then translated from English to Hindi.…”

Section: Methodsmentioning

confidence: 99%

How effective is community mobilisation in HIV prevention among highly diverse sex workers in urban settings? The Aastha intervention experience in Mumbai and Thane districts, India

Gaikwad¹,

Bhende²,

Nidhi³

et al. 2012

J Epidemiol Community Health

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“…At least one study from the United States has documented that engagement with community agencies serving MSM are more likely to be associated with safer sex behaviors among MSM, possibly due to the social support obtained from friendship networks and other resources of the community agencies [38]. Even though there is evidence of positive impact of collectivization on safer sex practices among female sex workers [39-42], there are hardly any studies on the effects of collectivization on safer sex practices among Indian MSM [43], which need to be explored further. Available evidence suggests that interventions involving community-building empowerment activities can lead to significant risk reduction in MSM [21,44].…”

Section: Discussionmentioning

confidence: 99%

Consistent condom use with regular, paying, and casual male partners and associated factors among men who have sex with men in Tamil Nadu, India: findings from an assessment of a large-scale HIV prevention program

Ramanathan¹,

Chakrapani

Ramakrishnan³

et al. 2013

BMC Public Health

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BackgroundMen who have sex with men (MSM) are a marginalized population at high risk for HIV infection. Promoting consistent condom use (CCU) during anal sex is a key risk reduction strategy for HIV prevention among MSM. To inform effective HIV prevention interventions, we examined the factors associated with CCU among MSM with their regular, paying, and casual partners, as well as with all three types of partners combined.MethodsData for this analysis were from a large-scale bio-behavioural survey conducted during 2009–2010 in Tamil Nadu, India. MSM aged 18 years or older were recruited for the survey using time-location cluster sampling at cruising sites in four districts of Tamil Nadu. Binary logistic regression analyses were conducted to assess the association of CCU with selected socio-demographic characteristics and other contextual factors.ResultsAmong 1618 MSM interviewed, CCU during anal sex with regular, paying, and a casual male partner was 45.3%, 50.8% and 57.9%, respectively. CCU with all three types of partners combined was 52.6%. Characteristics associated with increased odds for CCU with MSM having all three types of partners combined were frequent receptive anal sex acts with regular partners (adjusted odds ratio [AOR] 2.17, 95% confidence interval [CI] 1.01-4.65), fewer number of casual partners (AOR 3.41, 95% CI 1.50-7.73) and membership in a community-based organization (CBO) for MSM (AOR 3.54, 95% CI 1.62-7.74). CCU with regular partners was associated with membership in a CBO (AOR 1.96, 95% CI 1.23-3.11), whereas CCU with paying, and casual male partners was associated with perceived higher risk of acquiring HIV (AOR 1.92, 95% CI 1.22-3.01) and exposure to any HIV prevention intervention (AOR 3.62, 95% CI 1.31-10.0), respectively. Being aged 26 years or older, being in debt, and alcohol use were factors associated with inconsistent condom use across partner types.ConclusionHIV interventions among MSM need to promote CCU with all types (regular, paying, and causal) of male partners, and need to reach MSM across all age groups. In addition to enhancing interventions that focus on individual level risk reduction, it is important to undertake structural interventions that promote social acceptance of same-sex sexuality and address contextual barriers to condom use such as alcohol use.

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“…It is also evident from the previous studies that structural approaches and community mobilization are an integral part of successful interventions in reducing the HIV risk vulnerability among key populations (e.g. female sex workers, men having sex with men and injecting drug users) [30,33,36,37,[50][51][52][53]. When mental health in the context of community collectivization approach among MSM is discussed, there is negligible evidence in this sphere of mental health.…”

Section: Discussionmentioning

confidence: 99%

Association between Community Collectivization and Mental Depression among Men Who Have Sex with Men in Andhra Pradesh, India

Suryawanshi¹,

Sk²,

Sharma³

et al. 2016

Health Care: Current Reviews

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Community mobilisation programme for female sex workers in coastal Andhra Pradesh, India: processes and their effects

Abstract: Background This paper describes the process of setting up community-based organisations (CBOs) of sex workers during the 5-year community mobilisation

Cited by 23 publications

References 19 publications

How effective is community mobilisation in HIV prevention among highly diverse sex workers in urban settings? The Aastha intervention experience in Mumbai and Thane districts, India

How effective is community mobilisation in HIV prevention among highly diverse sex workers in urban settings? The Aastha intervention experience in Mumbai and Thane districts, India

Consistent condom use with regular, paying, and casual male partners and associated factors among men who have sex with men in Tamil Nadu, India: findings from an assessment of a large-scale HIV prevention program

Association between Community Collectivization and Mental Depression among Men Who Have Sex with Men in Andhra Pradesh, India

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