Client-Perpetrated & Husband-Perpetrated Violence among Female Sex Workers in Andhra Pradesh, India: HIV/STI Risk Across Personal & Work Contexts

OBJECTIVES:

This study examines violence experienced in work and personal contexts and relation to HIV risk factors in these contexts among female sex workers (FSW) in Andhra Pradesh, India.

METHODS:

FSW at least 18 years of age (n=2335) were recruited through three rounds of respondent-driven sampling between 2006 and 2010 for a survey on HIV risk. Using crude and adjusted logistic regression models, any sexual/physical violence (last 6 months) perpetrated by clients and husbands were separately assessed in association with accepting more money for sex without a condom (last 30 days), consistent condom use with clients and husbands (last 30 days), and sexually transmitted infection (STI) symptoms (last 6 months).

RESULTS:

The mean age among participants was 32, 22% reported being currently married, and 22% and 21% reported physical/sexual violence by clients and husbands, respectively. In adjusted logistic regression models, FSW who experienced client violence were more likely to report accepting more money for unprotected sex trades (adjusted OR (AOR)=1.7; 95% CI 1.4 to 2.2), less likely to report consistent condom use with clients (AOR=0.6; 95% CI 0.5 to 0.7) and more likely to report STI symptoms (AOR=3.5; 95% CI 2.6 to 4.6). Women who reported husband violence were more likely to report accepting more money for unprotected sex trades (AOR=2.1; 95% CI 1.2 to 3.7), less likely to report consistent condom use with clients (AOR=0.5; 95% CI 0.3 to 0.8) and more likely to report STI symptoms (AOR=2.6; 95% CI 1.6 to 4.1).

CONCLUSIONS:

Among FSW, experiences of violence in work and personal contexts are associated with sexual HIV risk behaviours with clients as well as STI symptoms.

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By:  Reed E1, Erausquin JT2, Groves AK3, Salazar M1, Biradavolu M3, Blankenship KM3.

• 1Division of Global Public Health, School of Medicine: La Jolla, University of California, San Diego, CA, USA.
• 2Department of Public Health Education, University of North Carolina, Greensboro, Greensboro, NC, USA.
• 3Department of Sociology, American University, Washington DC, USA. 
• Sex Transm Infect. 2016 Feb 23. pii: sextrans-2015-052162. doi: 10.1136/sextrans-2015-052162.

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