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Consistent Condom Use by Female Sex Workers in Kolkata, India: Testing Theories of Economic Insecurity, Behavior Change, Life Course Vulnerability and Empowerment

View Article: PubMed Central - PubMed

ABSTRACT

Consistent condom use (CCU) is the primary HIV/STI prevention option available to sex workers globally but may be undermined by economic insecurity, life-course vulnerabilities, behavioral factors, disempowerment, or lack of effective interventions. This study examines predictors of CCU in a random household survey of brothel-based female sex workers (n = 200) in two neighborhoods served by Durbar (the Sonagachi Project) in Kolkata, India. Multivariate logistic regression analyses indicated that CCU was significantly associated with perceived HIV risk, community mobilization participation, working more days in sex work, and higher proportion of occasional clients to regular clients. Exploratory analyses stratifying by economic insecurity indicators (i.e., debt, savings, income, housing security) indicate that perceived HIV risk and community mobilization were only associated with CCU for economically secure FSW. Interventions with FSW must prioritize economic security and access to social protections as economic insecurity may undermine the efficacy of more direct condom use intervention strategies.

No MeSH data available.


Graph of interaction of the number of occasional clients by the number of regular clients in the last week on predicted probabilities of condom use with last occasional client
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Fig2: Graph of interaction of the number of occasional clients by the number of regular clients in the last week on predicted probabilities of condom use with last occasional client

Mentions: Consistent condom use (CCU) with both last occasional client and last regular client (see Table 3) was most strongly associated with participating in door-to-door mobilization campaigns (OR = 3.54, 95 % CI 1.39–8.99, p = 0.008), perceived risk for HIV (OR = 3.11, 95 % CI 1.31–7.37, p = 0.010), and number of days of sex work in the last week (OR = 1.64, 95 % CI 1.25–2.16, p < 0.0001). The association between consistent condom use and serving as a peer educator was marginally insignificant (OR = 2.65, 95 % CI 0.98–7.14, p = 0.054). The interaction of the number of occasional clients by the number of regular clients was also associated with CCU (OR 1.10, 95 % CI 1.03–1.18, p = 0.004). Figure 2 shows a graph of interaction. Among those with a very low or moderately low number of occasional clients, the odds of CCU did not significantly change with each additional regular client. By contrast, for those with a medium or high number of occasional clients, the odds of CCU increased with each additional regular client.Fig. 2


Consistent Condom Use by Female Sex Workers in Kolkata, India: Testing Theories of Economic Insecurity, Behavior Change, Life Course Vulnerability and Empowerment
Graph of interaction of the number of occasional clients by the number of regular clients in the last week on predicted probabilities of condom use with last occasional client
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016559&req=5

Fig2: Graph of interaction of the number of occasional clients by the number of regular clients in the last week on predicted probabilities of condom use with last occasional client
Mentions: Consistent condom use (CCU) with both last occasional client and last regular client (see Table 3) was most strongly associated with participating in door-to-door mobilization campaigns (OR = 3.54, 95 % CI 1.39–8.99, p = 0.008), perceived risk for HIV (OR = 3.11, 95 % CI 1.31–7.37, p = 0.010), and number of days of sex work in the last week (OR = 1.64, 95 % CI 1.25–2.16, p < 0.0001). The association between consistent condom use and serving as a peer educator was marginally insignificant (OR = 2.65, 95 % CI 0.98–7.14, p = 0.054). The interaction of the number of occasional clients by the number of regular clients was also associated with CCU (OR 1.10, 95 % CI 1.03–1.18, p = 0.004). Figure 2 shows a graph of interaction. Among those with a very low or moderately low number of occasional clients, the odds of CCU did not significantly change with each additional regular client. By contrast, for those with a medium or high number of occasional clients, the odds of CCU increased with each additional regular client.Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

Consistent condom use (CCU) is the primary HIV/STI prevention option available to sex workers globally but may be undermined by economic insecurity, life-course vulnerabilities, behavioral factors, disempowerment, or lack of effective interventions. This study examines predictors of CCU in a random household survey of brothel-based female sex workers (n&nbsp;=&nbsp;200) in two neighborhoods served by Durbar (the Sonagachi Project) in Kolkata, India. Multivariate logistic regression analyses indicated that CCU was significantly associated with perceived HIV risk, community mobilization participation, working more days in sex work, and higher proportion of occasional clients to regular clients. Exploratory analyses stratifying by economic insecurity indicators (i.e., debt, savings, income, housing security) indicate that perceived HIV risk and community mobilization were only associated with CCU for economically secure FSW. Interventions with FSW must prioritize economic security and access to social protections as economic insecurity may undermine the efficacy of more direct condom use intervention strategies.

No MeSH data available.