Background
Violence against sex
workers can heighten their vulnerability to HIV and other sexually transmitted
infections (STIs). Evidence suggests the risk of acquiring STI/HIV infections
among female sex workers (FSWs) who have experienced violence to be almost three-times
higher than FSWs, who have not experienced violence. Moreover, an experience of
physical and sexual violence makes it difficult for them to negotiate safer sex
with their partners and often act as a barrier to utilization of prevention
services.
Methods
This study utilizes data
from 2785 FSWs aged 18 years and above who participated in a cross-sectional
behavioural study conducted during 2013–14 in Thane district, Maharashtra. A
probability-based two-stage cluster sampling method was used for data collection.
This study assesses the effect of physical violence on self-reported STI
symptoms (any STI and multiple STIs) and treatment seeking for the last STI
symptom using propensity score matching method.
Results
About 18% of sampled
FSWs reported physical violence at the time of the survey. The likelihood of
experiencing such violence was significantly higher among FSWs who solicited
clients at public places, engaged in other economic activities apart from sex
work, had savings, and reported high client volume per week. FSWs experiencing
violence were also inconsistent condom users while engaging in sex with regular
partners and clients. The average adjusted effect of violence clearly depicted
an increase in the risk of any STI (11%, p<0.05) and multiple STIs (8%,
p<0.10) and reduction in treatment seeking (10%, p<0.05).
Conclusions
This study demonstrates
a significant effect of physical violence on reporting of any STI symptom and
treatment seeking. Findings call for the immediate inclusion of strategies
aimed to address violence related challenges in HIV prevention program
currently being provided at Thane district. Such strategies would further help
in enhancing the access to tailored STI prevention and care services among FSWs
in the district.
Below: Percentage of FSWs experienced physical Violence by type of partners, Thane, 2014
Below: Predicted probability of experiencing physical violence; matched sample, Thane, 2014
By:
Alash'le G. Abimiku, Editor
HIV/AIDS
Partnership for Impact through Prevention, Private Sector and Evidence-based
Programming (PIPPSE) Project, Public Health Foundation of India, New Delhi,
India
University of
Maryland School of Medicine
More at: https://twitter.com/hiv insight
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