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Sustaining consistent condom use among female sex workers by addressing their vulnerabilities and strengthening community-led organizations in India

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  • Bidhubhusan Mahapatra
  • Monika Walia
  • Sangram Kishor Patel
  • Madhusudana Battala
  • Saradiya Mukherjee
  • Prachi Patel
  • Balakrishnan Subramanium
  • Yamini Atmavilas
  • Niranjan Saggurti

Abstract

Introduction: Between 2014 and 2017, a program aimed at reducing HIV risk and promoting safe sex through consistent use of condoms sought to work through addressing social and economic vulnerabilities and strengthening community-led organizations (COs) of female sex workers (FSWs). This study examines if the program was effective by studying relationship between strengthening of COs, vulnerability reduction, and sustaining of consistent condom use behavior among FSWs. Methods: We used a longitudinal study design to assess the change in outcomes. A three-stage sampling design was used to select FSWs for the study. Panel data of 2085 FSWs selected from 38 COs across five states of India was used to examine the change in various outcomes from 2015 (Survey Round 1) to 2017 (Survey Round 2). The CO level program pillar measuring institutional development assessed performance of COs in six domains critical for any organization’s functionality and sustainability: governance, project management, financial management, program monitoring, advocacy and networking, and resource mobilization. Overall, 32 indicators from all these domains were used to compute the CO strength score. A score was computed by taking mean of average dimension scores. The overall score was divided into two groups based on the median cutoff; COs which scored below the median were considered to have low CO strength, while COs which scored above or equal to median were considered to have high CO strength. Multivariable regression modeling techniques were used to examine the effect of program pillars on outcome measures. Results: Analyses showed a significant improvement in the strength of the COs over time; percentage of COs having high strength improved from 50% in 2015 to 87% in Round 2. The improvement in CO’s strength increased financial security (Adjusted Odds Ratio [AOR]: 2.18, p

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  • Bidhubhusan Mahapatra & Monika Walia & Sangram Kishor Patel & Madhusudana Battala & Saradiya Mukherjee & Prachi Patel & Balakrishnan Subramanium & Yamini Atmavilas & Niranjan Saggurti, 2020. "Sustaining consistent condom use among female sex workers by addressing their vulnerabilities and strengthening community-led organizations in India," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-17, July.
    • Handle: RePEc:plo:pone00:0235094
    DOI: 10.1371/journal.pone.0235094
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    References listed on IDEAS

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    1. Bidhubhusan Mahapatra & Ruchira Bhattacharya & Yamini Atmavilas & Niranjan Saggurti, 2018. "Measuring vulnerability among female sex workers in India using a multidimensional framework," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-13, September.
    2. Annie George & Kim M Blankenship, 2015. "Peer Outreach Work as Economic Activity: Implications for HIV Prevention Interventions among Female Sex Workers," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-14, March.
    3. Beattie, T.S.H. & Mohan, H.L. & Bhattacharjee, P. & Chandrashekar, S. & Isac, S. & Wheeler, T. & Prakash, R. & Ramesh, B.M. & Blanchard, J.F. & Heise, L. & Vickerman, P. & Moses, S. & Watts, C., 2014. "Community mobilization and empowerment of female sex workers in karnataka state, south india: Associations with hiv and sexually transmitted infection risk," American Journal of Public Health, American Public Health Association, vol. 104(8), pages 1516-1525.
    4. Shalini Bharat & Bidhubhusan Mahapatra & Suchismita Roy & Niranjan Saggurti, 2013. "Are Female Sex Workers Able to Negotiate Condom Use with Male Clients? The Case of Mobile FSWs in Four High HIV Prevalence States of India," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-8, June.
    5. Swendeman, Dallas & Basu, Ishika & Das, Sankari & Jana, Smarajit & Rotheram-Borus, Mary Jane, 2009. "Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases," Social Science & Medicine, Elsevier, vol. 69(8), pages 1157-1166, October.
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