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Declines in risk behaviour and sexually transmitted infection prevalence following a community-led hiv preventive intervention among female sex workers in mysore, india.

Publication year: 
Author (s): 
Reza-Paul, S; Beattie, T; Ur, R; Syed, H [et al.]
Corporate author: 
Wolters Kluwer Health.
Publication details: 
Washington, Wolters Kluwer Health, 2008
Publication in: 
AIDS 2008, 22 (suppl 5):S91–S100

Objective: To investigate the impact on sexual behaviour and sexually transmitted
infections (STIs) 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%, P¼0.001; gonorrhoea 5% versus 2%, P¼0.03. 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.