Community Collectivization and Consistent Condom Use among Female Sex Workers in Southern India: Evidence from Two Rounds of Behavioral Tracking Surveys

October 2015 - Behavioral Prevention

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Vejella, S., Patel, S.K., Saggurti, N., and Prabhakar, P. AIDS and Behavior (August 2015), E-publication ahead of print.

This study assessed how community collectivization influenced consistent condom use (CCU) by female sex workers (FSWs) with different types of partners. Community collectivization empowers key populations as a group to reduce their vulnerability and improve their ability to control and make decisions about their own behaviors and ultimately, to adopt and maintain healthy behaviors. The authors collected data from two rounds of cross-sectional surveys in 2010 (N1 = 1,986) and 2012 (N2 = 1,973) among FSWs in Andhra Pradesh, India. The authors found that CCU with occasional clients increased significantly from 2010 (72 percent) to 2012 (85 percent). CCU with regular clients also increased, from 64 percent (2010) to 76 percent (2012). Moreover, FSWs who reported a high degree of collective efficacy were more likely than those who reported low levels of collective efficacy to report CCU with occasional clients (72 percent versus 73 percent in 2010, and 59 percent versus 90 percent in 2012). The authors concluded that structural interventions such as community collectivization for HIV prevention can have a positive, sustained impact on behavior change among FSWs, both by enhancing FSWs’ self-efficacy and self-confidence, and ensuring the continued practice of safe sex behaviors. They recommended that new and existing structural interventions programs consider including community mobilization.

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