Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project

Virupax Ranebennur,1 Sanjeevsingh Gaikwad,1 Sowmya Ramesh,2 Amrita Bhende1 1FHI 360, Maharashtra, Mumbai, India; 2HIV/AIDS Programs, Population Council, New Delhi, India Background: It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty,...

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Autores principales:	Ranebennur V, Gaikwad S, Ramesh S, Bhende A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/ff47bc95486f4bd3a185b7e436223589
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spelling	oai:doaj.org-article:ff47bc95486f4bd3a185b7e4362235892021-12-02T00:28:42ZAddressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project1179-1373https://doaj.org/article/ff47bc95486f4bd3a185b7e4362235892014-02-01T00:00:00Zhttp://www.dovepress.com/addressing-vulnerabilities-of-female-sex-workers-in-an-hiv-prevention--a15871https://doaj.org/toc/1179-1373 Virupax Ranebennur,1 Sanjeevsingh Gaikwad,1 Sowmya Ramesh,2 Amrita Bhende1 1FHI 360, Maharashtra, Mumbai, India; 2HIV/AIDS Programs, Population Council, New Delhi, India Background: It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Materials and methods: Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Results: Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4–3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2–4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2–3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0–2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. Conclusion: It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community involvement, in order to strengthen the structural response to HIV prevention. Keywords: HIV, vulnerability, FSWs, India, preventionRanebennur VGaikwad SRamesh SBhende ADove Medical PressarticleImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2014, Iss default, Pp 9-18 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Ranebennur V Gaikwad S Ramesh S Bhende A Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project
description	Virupax Ranebennur,1 Sanjeevsingh Gaikwad,1 Sowmya Ramesh,2 Amrita Bhende1 1FHI 360, Maharashtra, Mumbai, India; 2HIV/AIDS Programs, Population Council, New Delhi, India Background: It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Materials and methods: Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Results: Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4–3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2–4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2–3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0–2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. Conclusion: It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community involvement, in order to strengthen the structural response to HIV prevention. Keywords: HIV, vulnerability, FSWs, India, prevention
format	article
author	Ranebennur V Gaikwad S Ramesh S Bhende A
author_facet	Ranebennur V Gaikwad S Ramesh S Bhende A
author_sort	Ranebennur V
title	Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project
title_short	Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project
title_full	Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project
title_fullStr	Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project
title_full_unstemmed	Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project
title_sort	addressing vulnerabilities of female sex workers in an hiv prevention intervention in mumbai and thane: experiences from the aastha project
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/ff47bc95486f4bd3a185b7e436223589
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Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project

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