Bhattacharjee, P., Isac, S., McClarty, L.M., et al. Journal of the International AIDS Society (2016), 19(Suppl 3): 20856, doi: http://dx.doi.org/10.7448/IAS.19.4.20856.
This study (2005–2011) examined a structural intervention to reduce police arrest among female sex workers (FSWs) in India. Arrested FSWs may be sexually abused by police; engage in risky (including condomless) sex to pay arrest costs; have condoms confiscated by police; and move to avoid arrest—reducing their community support and increasing HIV vulnerability. The intervention included one-day sensitization workshops with police to educate them on existing laws covering FSWs, human rights and abuse penalties, and FSWs' daily struggles. Interventions for FSWs entailed formation of peer support groups, training on rights and how to report violence to police, and development of crisis management teams, including a 24-hour hotline and a human rights lawyer to address emergencies. As part of integrated biological and behavioral assessment surveys, FSWs were interviewed at 20-month intervals about their experiences. Interviews with 4,110 FSWs, showed that while 5.5 percent initially reported experiencing arrest, only 2.8 percent did 20 months later. Peer support also increased: 40.75 percent of FSWs initially reported having peer support, which increased to nearly 70 percent 20 months later. The authors concluded that in settings where sex work is criminalized, structural interventions that educate police officers can be an effective approach for reducing HIV risk among FSWs.