Declines in violence and police arrest among female sex workers in Karnataka state, south India, following a comprehensive HIV prevention programme

Introduction Female sex workers (FSWs) frequently experience violence, harassment and arrest by the police or their clients, but there is little evidence as to the impact that such factors may have on HIV risk or whether community interventions could mitigate this impact. Methods As part of the eval...

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Veröffentlicht in:Journal of the International AIDS Society 2015-01, Vol.18 (1), p.20079-n/a
Hauptverfasser: Beattie, Tara S, Bhattacharjee, Parinita, Isac, Shajy, Mohan, HL, Simic‐Lawson, Milena, Ramesh, BM, Blanchard, James F, Moses, Stephen, Watts, Charlotte H, Heise, Lori
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container_start_page 20079
container_title Journal of the International AIDS Society
container_volume 18
creator Beattie, Tara S
Bhattacharjee, Parinita
Isac, Shajy
Mohan, HL
Simic‐Lawson, Milena
Ramesh, BM
Blanchard, James F
Moses, Stephen
Watts, Charlotte H
Heise, Lori
description Introduction Female sex workers (FSWs) frequently experience violence, harassment and arrest by the police or their clients, but there is little evidence as to the impact that such factors may have on HIV risk or whether community interventions could mitigate this impact. Methods As part of the evaluation of the Avahan programme in Karnataka, serial integrated behavioural and biological assessment (IBBA) surveys (four districts) (2005 to 2011) and anonymous polling booth surveys (PBS) (16 districts) (2007 to 2011) were conducted with random samples of FSWs. Logistic regression analysis was used to assess 1) changes in reported violence and arrests over time and 2) associations between violence by non‐partners and police arrest and HIV/STI risk and prevalence. Mediation analysis was used to identify mediating factors. Results 5,792 FSWs participated in the IBBAs and 15,813 participated in the PBS. Over time, there were significant reductions in the percentages of FSWs reporting being raped in the past year (PBS) (30.0% in 2007, 10.0% in 2011, p
doi_str_mv 10.7448/IAS.18.1.20079
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Methods As part of the evaluation of the Avahan programme in Karnataka, serial integrated behavioural and biological assessment (IBBA) surveys (four districts) (2005 to 2011) and anonymous polling booth surveys (PBS) (16 districts) (2007 to 2011) were conducted with random samples of FSWs. Logistic regression analysis was used to assess 1) changes in reported violence and arrests over time and 2) associations between violence by non‐partners and police arrest and HIV/STI risk and prevalence. Mediation analysis was used to identify mediating factors. Results 5,792 FSWs participated in the IBBAs and 15,813 participated in the PBS. Over time, there were significant reductions in the percentages of FSWs reporting being raped in the past year (PBS) (30.0% in 2007, 10.0% in 2011, p<0.001), being arrested in the past year [adjusted odds ratio (AOR) 0.57 (0.35, 0.93), p=0.025] and being beaten in the past six months by a non‐partner (clients, police, pimps, strangers, rowdies) [AOR 0.69 (0.49, 0.95), p=0.024)] (IBBA). The proportion drinking alcohol (during the past week) also fell significantly (32.5% in 2005, 24.9% in 2008, 16.8% in 2011; p<0.001). Violence by non‐partners (being raped in the past year and/or beaten in the past six months) and being arrested in the past year were both strongly associated with HIV infection [AOR 1.59 (1.18, 2.15), p=0.002; AOR 1.91 (1.17, 3.12), p=0.01, respectively]. They were also associated with drinking alcohol (during the past week) [AOR 1.98 (1.54, 2.53), p<0.001; AOR 2.79 (1.93, 4.04), p<0.001, respectively], reduced condom self‐efficacy with clients [AOR 0.36 (0.27, 0.47), p<0.001; AOR 0.62 (0.39, 0.98), p=0.039, respectively], symptomatic STI (during the past year) [AOR 2.62 (2.07, 3.30), p<0.001; AOR 2.17 (1.51, 3.13), p<0.001, respectively], gonorrhoea infection [AOR 2.79 (1.51, 5.15), p=0.001; AOR 2.69 (0.96, 7.56), p=0.060, respectively] and syphilis infection [AOR 1.86 (1.04, 3.31), p=0.036; AOR 3.35 (1.78, 6.28), p<0.001, respectively], but not with exposure to peer education, community mobilization or HIV testing uptake. Mediation analysis suggests that alcohol use and STIs may partially mediate the association between violence or arrests and HIV prevalence. Discussion Violence by non‐partners and arrest are both strongly associated with HIV infection among FSWs. Large‐scale, comprehensive HIV prevention programming can reduce violence, arrests and HIV/STI infection among FSWs.]]></description><identifier>ISSN: 1758-2652</identifier><identifier>EISSN: 1758-2652</identifier><identifier>DOI: 10.7448/IAS.18.1.20079</identifier><identifier>PMID: 26477992</identifier><language>eng</language><publisher>Switzerland: International AIDS Society</publisher><subject>Acquired immune deficiency syndrome ; Adult ; AIDS ; AIDS/HIV ; alcohol ; Alcohol use ; Arrest ; Arrests ; Community health services ; Disease prevention ; Domestic violence ; Female ; female sex work ; Health aspects ; Health risks ; HIV ; HIV infection ; HIV Infections - prevention &amp; control ; HIV prevention ; Human immunodeficiency virus ; Humans ; India ; India - epidemiology ; Logistic Models ; Mental health ; Police ; Prevention ; Prostitutes ; Regression analysis ; Risk factors ; Sex industry ; Sex oriented businesses ; Sex Workers - statistics &amp; numerical data ; Sexual behavior ; Sexually transmitted disease prevention ; Sexually transmitted diseases ; Sexually Transmitted Diseases - epidemiology ; Statistics ; STD ; structural drivers ; Syphilis ; Violence ; Violence - prevention &amp; control ; Womens health ; Workers ; Working women</subject><ispartof>Journal of the International AIDS Society, 2015-01, Vol.18 (1), p.20079-n/a</ispartof><rights>2015 Beattie T S et al; licensee International AIDS Society</rights><rights>COPYRIGHT 2015 International AIDS Society</rights><rights>COPYRIGHT 2015 John Wiley &amp; Sons, Inc.</rights><rights>2015. 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Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Beattie TS et al; licensee International AIDS Society 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c7639-82057c717589bc898ce4331867cfc09d26ffa03b2a50fd83dc4dd2744d52c5593</citedby><cites>FETCH-LOGICAL-c7639-82057c717589bc898ce4331867cfc09d26ffa03b2a50fd83dc4dd2744d52c5593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609649/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609649/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1417,11562,27924,27925,45574,45575,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26477992$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beattie, Tara S</creatorcontrib><creatorcontrib>Bhattacharjee, Parinita</creatorcontrib><creatorcontrib>Isac, Shajy</creatorcontrib><creatorcontrib>Mohan, HL</creatorcontrib><creatorcontrib>Simic‐Lawson, Milena</creatorcontrib><creatorcontrib>Ramesh, BM</creatorcontrib><creatorcontrib>Blanchard, James F</creatorcontrib><creatorcontrib>Moses, Stephen</creatorcontrib><creatorcontrib>Watts, Charlotte H</creatorcontrib><creatorcontrib>Heise, Lori</creatorcontrib><title>Declines in violence and police arrest among female sex workers in Karnataka state, south India, following a comprehensive HIV prevention programme</title><title>Journal of the International AIDS Society</title><addtitle>J Int AIDS Soc</addtitle><description><![CDATA[Introduction Female sex workers (FSWs) frequently experience violence, harassment and arrest by the police or their clients, but there is little evidence as to the impact that such factors may have on HIV risk or whether community interventions could mitigate this impact. Methods As part of the evaluation of the Avahan programme in Karnataka, serial integrated behavioural and biological assessment (IBBA) surveys (four districts) (2005 to 2011) and anonymous polling booth surveys (PBS) (16 districts) (2007 to 2011) were conducted with random samples of FSWs. Logistic regression analysis was used to assess 1) changes in reported violence and arrests over time and 2) associations between violence by non‐partners and police arrest and HIV/STI risk and prevalence. Mediation analysis was used to identify mediating factors. Results 5,792 FSWs participated in the IBBAs and 15,813 participated in the PBS. Over time, there were significant reductions in the percentages of FSWs reporting being raped in the past year (PBS) (30.0% in 2007, 10.0% in 2011, p<0.001), being arrested in the past year [adjusted odds ratio (AOR) 0.57 (0.35, 0.93), p=0.025] and being beaten in the past six months by a non‐partner (clients, police, pimps, strangers, rowdies) [AOR 0.69 (0.49, 0.95), p=0.024)] (IBBA). The proportion drinking alcohol (during the past week) also fell significantly (32.5% in 2005, 24.9% in 2008, 16.8% in 2011; p<0.001). Violence by non‐partners (being raped in the past year and/or beaten in the past six months) and being arrested in the past year were both strongly associated with HIV infection [AOR 1.59 (1.18, 2.15), p=0.002; AOR 1.91 (1.17, 3.12), p=0.01, respectively]. They were also associated with drinking alcohol (during the past week) [AOR 1.98 (1.54, 2.53), p<0.001; AOR 2.79 (1.93, 4.04), p<0.001, respectively], reduced condom self‐efficacy with clients [AOR 0.36 (0.27, 0.47), p<0.001; AOR 0.62 (0.39, 0.98), p=0.039, respectively], symptomatic STI (during the past year) [AOR 2.62 (2.07, 3.30), p<0.001; AOR 2.17 (1.51, 3.13), p<0.001, respectively], gonorrhoea infection [AOR 2.79 (1.51, 5.15), p=0.001; AOR 2.69 (0.96, 7.56), p=0.060, respectively] and syphilis infection [AOR 1.86 (1.04, 3.31), p=0.036; AOR 3.35 (1.78, 6.28), p<0.001, respectively], but not with exposure to peer education, community mobilization or HIV testing uptake. Mediation analysis suggests that alcohol use and STIs may partially mediate the association between violence or arrests and HIV prevalence. Discussion Violence by non‐partners and arrest are both strongly associated with HIV infection among FSWs. Large‐scale, comprehensive HIV prevention programming can reduce violence, arrests and HIV/STI infection among FSWs.]]></description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>AIDS</subject><subject>AIDS/HIV</subject><subject>alcohol</subject><subject>Alcohol use</subject><subject>Arrest</subject><subject>Arrests</subject><subject>Community health services</subject><subject>Disease prevention</subject><subject>Domestic violence</subject><subject>Female</subject><subject>female sex work</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV infection</subject><subject>HIV Infections - prevention &amp; control</subject><subject>HIV prevention</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>India</subject><subject>India - epidemiology</subject><subject>Logistic Models</subject><subject>Mental health</subject><subject>Police</subject><subject>Prevention</subject><subject>Prostitutes</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Sex industry</subject><subject>Sex oriented businesses</subject><subject>Sex Workers - statistics &amp; numerical data</subject><subject>Sexual behavior</subject><subject>Sexually transmitted disease prevention</subject><subject>Sexually transmitted diseases</subject><subject>Sexually Transmitted Diseases - epidemiology</subject><subject>Statistics</subject><subject>STD</subject><subject>structural drivers</subject><subject>Syphilis</subject><subject>Violence</subject><subject>Violence - prevention &amp; control</subject><subject>Womens health</subject><subject>Workers</subject><subject>Working women</subject><issn>1758-2652</issn><issn>1758-2652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqNk01v1DAQhiMEoqVw5YgsISEO3cV2Eju-VFqVjy5U4sDH1XKdya5bx17sZJf-Dv4wTreUXbRaqhwySZ73nfFkJsueEzzmRVG9mU6-jEk1JmOKMRcPskPCy2pEWUkfbsQH2ZMYLzFmtCrE4-yAsoJzIehh9ustaGscRGQcWhpvwWlAytVo4a0ZwhAgdki13s1QA62ygCL8RCsfriDcyD6p4FSnrhSKnergGEXfd3M0dbVRx6jx1vqVSWqFtG8XAebgolkCOpt-R-lxCa4z3qXQz4JqW3iaPWqUjfDs9n6UfXv_7uvp2ej884fp6eR8pDnLxaiiuOSaD4cUF7oSlYYiz0nFuG40FjVlTaNwfkFViZu6ymtd1DVNXatLqstS5EfZydp30V-0UOtUR1BWLoJpVbiWXhm5_cWZuZz5pSwYFqwYDF7fGgT_o09tkq2JGqxVDnwfJeG0oKXAOUvoy3_QS9-nttkoc8w4o5SxvRSlAleYMyb-UrP0M6RxjU_V6SG1nHDCGOEE471UkZdEYJYXiRrtoGbgIB3YO2hMer3leh9-03-8g09XDa3ROxPcS7CZ4dWGYA7KdvPobT_MVNx23gvuqFkHH2OA5m4kCJbD1sm0dZJUksibrUuCF5uDdIf_WbMEFGtglYq__o-d_DidrH1_A81gMwc</recordid><startdate>201501</startdate><enddate>201501</enddate><creator>Beattie, Tara S</creator><creator>Bhattacharjee, Parinita</creator><creator>Isac, Shajy</creator><creator>Mohan, HL</creator><creator>Simic‐Lawson, Milena</creator><creator>Ramesh, BM</creator><creator>Blanchard, James F</creator><creator>Moses, Stephen</creator><creator>Watts, Charlotte H</creator><creator>Heise, Lori</creator><general>International AIDS Society</general><general>John Wiley &amp; 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numerical data</topic><topic>Sexual behavior</topic><topic>Sexually transmitted disease prevention</topic><topic>Sexually transmitted diseases</topic><topic>Sexually Transmitted Diseases - epidemiology</topic><topic>Statistics</topic><topic>STD</topic><topic>structural drivers</topic><topic>Syphilis</topic><topic>Violence</topic><topic>Violence - prevention &amp; control</topic><topic>Womens health</topic><topic>Workers</topic><topic>Working women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beattie, Tara S</creatorcontrib><creatorcontrib>Bhattacharjee, Parinita</creatorcontrib><creatorcontrib>Isac, Shajy</creatorcontrib><creatorcontrib>Mohan, HL</creatorcontrib><creatorcontrib>Simic‐Lawson, Milena</creatorcontrib><creatorcontrib>Ramesh, BM</creatorcontrib><creatorcontrib>Blanchard, James F</creatorcontrib><creatorcontrib>Moses, Stephen</creatorcontrib><creatorcontrib>Watts, Charlotte H</creatorcontrib><creatorcontrib>Heise, Lori</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; 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Methods As part of the evaluation of the Avahan programme in Karnataka, serial integrated behavioural and biological assessment (IBBA) surveys (four districts) (2005 to 2011) and anonymous polling booth surveys (PBS) (16 districts) (2007 to 2011) were conducted with random samples of FSWs. Logistic regression analysis was used to assess 1) changes in reported violence and arrests over time and 2) associations between violence by non‐partners and police arrest and HIV/STI risk and prevalence. Mediation analysis was used to identify mediating factors. Results 5,792 FSWs participated in the IBBAs and 15,813 participated in the PBS. Over time, there were significant reductions in the percentages of FSWs reporting being raped in the past year (PBS) (30.0% in 2007, 10.0% in 2011, p<0.001), being arrested in the past year [adjusted odds ratio (AOR) 0.57 (0.35, 0.93), p=0.025] and being beaten in the past six months by a non‐partner (clients, police, pimps, strangers, rowdies) [AOR 0.69 (0.49, 0.95), p=0.024)] (IBBA). The proportion drinking alcohol (during the past week) also fell significantly (32.5% in 2005, 24.9% in 2008, 16.8% in 2011; p<0.001). Violence by non‐partners (being raped in the past year and/or beaten in the past six months) and being arrested in the past year were both strongly associated with HIV infection [AOR 1.59 (1.18, 2.15), p=0.002; AOR 1.91 (1.17, 3.12), p=0.01, respectively]. They were also associated with drinking alcohol (during the past week) [AOR 1.98 (1.54, 2.53), p<0.001; AOR 2.79 (1.93, 4.04), p<0.001, respectively], reduced condom self‐efficacy with clients [AOR 0.36 (0.27, 0.47), p<0.001; AOR 0.62 (0.39, 0.98), p=0.039, respectively], symptomatic STI (during the past year) [AOR 2.62 (2.07, 3.30), p<0.001; AOR 2.17 (1.51, 3.13), p<0.001, respectively], gonorrhoea infection [AOR 2.79 (1.51, 5.15), p=0.001; AOR 2.69 (0.96, 7.56), p=0.060, respectively] and syphilis infection [AOR 1.86 (1.04, 3.31), p=0.036; AOR 3.35 (1.78, 6.28), p<0.001, respectively], but not with exposure to peer education, community mobilization or HIV testing uptake. Mediation analysis suggests that alcohol use and STIs may partially mediate the association between violence or arrests and HIV prevalence. Discussion Violence by non‐partners and arrest are both strongly associated with HIV infection among FSWs. Large‐scale, comprehensive HIV prevention programming can reduce violence, arrests and HIV/STI infection among FSWs.]]></abstract><cop>Switzerland</cop><pub>International AIDS Society</pub><pmid>26477992</pmid><doi>10.7448/IAS.18.1.20079</doi><tpages>16</tpages><oa>free_for_read</oa></addata></record>
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subjects Acquired immune deficiency syndrome
Adult
AIDS
AIDS/HIV
alcohol
Alcohol use
Arrest
Arrests
Community health services
Disease prevention
Domestic violence
Female
female sex work
Health aspects
Health risks
HIV
HIV infection
HIV Infections - prevention & control
HIV prevention
Human immunodeficiency virus
Humans
India
India - epidemiology
Logistic Models
Mental health
Police
Prevention
Prostitutes
Regression analysis
Risk factors
Sex industry
Sex oriented businesses
Sex Workers - statistics & numerical data
Sexual behavior
Sexually transmitted disease prevention
Sexually transmitted diseases
Sexually Transmitted Diseases - epidemiology
Statistics
STD
structural drivers
Syphilis
Violence
Violence - prevention & control
Womens health
Workers
Working women
title Declines in violence and police arrest among female sex workers in Karnataka state, south India, following a comprehensive HIV prevention programme
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