1. Trends in risk behaviors among female sex workers in south India: Priorities for sustaining the reversal of HIV epidemic.
- Author
-
Charles, Bimal, Jeyaseelan, Lakshmanan, Edwin Sam, Asirvatham, Kumar Pandian, Arvind, Thenmozhi, Mani, and Jeyaseelan, Visalakshi
- Subjects
- *
SEX work , *HIV infection epidemiology , *ANALYSIS of variance , *CHI-squared test , *CONDOMS , *CONFIDENCE intervals , *EPIDEMIOLOGY , *INTERVIEWING , *RESEARCH methodology , *QUESTIONNAIRES , *RESEARCH funding , *RISK-taking behavior , *DATA analysis , *UNSAFE sex , *CROSS-sectional method , *DATA analysis software , *DESCRIPTIVE statistics , *PSYCHOLOGY ,HIV infections & psychology - Abstract
HIV epidemic in India is predominantly concentrated in subgroups of population, such as female sex workers (FSWs) and their clients, whose behavior exposes them to a higher risk of acquiring HIV infection. This paper aims to present the changing patterns of socio-demographic characteristics, behaviors, reported sexually transmitted infections (STIs), and associated factors among FSWs over 11 years. Multistage cluster sampling with probability-proportional-to-size (PPS) method was used in the surveys. A sample of 400 FSWs was studied every year. The mean age and literacy at the baseline level increased significantly over the years. House-based sex increased by 40% from 43.3% in 1997 to 83% in 2008 (p<0.001). Condom use at last sex with one-time clients; consistent condom use (CCU) with one-time and regular clients indicated increasing trends. FSWs reported low levels of condom use at last sex (14.5% in 1997 to 5% in 2008;p<0.001) and CCU (12.6% in 2004 to 3.6% in 2008;p<0.01) with regular partners. FSWs who used condom with one-time clients at last sex reported significantly less STI symptoms. A two-third reduction in genital ulcers was found from 13.1% in 1997 to 4.5% in 2008 (p<0.001). Nonliterate and hotel-based sex workers were 1.6 (1.0–2.5; 95% CI) and 2.2(1.3–3.7; 95% CI) times more likely to have reported STI symptoms. The percentage of FSWs who underwent HIV testing increased (p<0.001); similarly, a 20% increase was found in FSWs who availed counseling services from 65.2% in 1997 to 85.4% in 2008 (p<0.001). Poor, illiterate, and marginalized were more likely to get involved in risky behaviors which suggest the need for structural interventions as part of HIV prevention strategy. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF