Sexual violence has been
shown to increase women’s risk of HIV infection. India is a country where the
HIV epidemic is growing among women and intimate partner violence is pervasive.
This study examined prevalence of and factors associated with forced sex among
female sex workers (FSWs) in Chennai, India. We conducted a probability survey
among FSWs in 24 slum venues and identified predictive factors for recent
forced sex using univariate and multivariable proportional odds models.
Among
522 FSWs, 28% reported having forced sex with 1 partner and 35% with 2+
partners. In the final multivariable model, women who had a high number of partners
who had a strong tendency to drink alcohol before sex were more likely to have
experienced forced sex, and women who had both unprotected sex with a
nonspousal partner and > 20 days of alcohol consumption in the last 30 days
were more likely to have experienced forced sex.
Discussion about family
violence with larger social networks was independently associated with lower
odds of forced sex among FSWs. HIV interventions for FSWs and their clients
aimed at reducing alcohol consumption and encouraging condom use could be
enhanced by violence prevention interventions to facilitate discourse about
sexual violence.
Multivariate Proportional Odds Model Results for Forced Sex (with 2 or more partners; with any partners) Among Sex Workers in Chennai, India
| Independent Variable Combinations | OR [95% CI] | |
|---|---|---|
| Any unprotected sex with non-spousal partner in last 3 mos? | ||
| No. days alcohol consumed in last 30 days | ||
| No | 0–9 | reference |
| 10–19 | 0.60 [0.24,1.48] | |
| 20+ | 0.36 [0.11,1.13] | |
| Yes | 0–9 | 1.42 [0.82,2.46] |
| 10–19 | 1.71 [0.82,3.56] | |
| 20+ | 2.66 [1.13,6.29] | |
| No. people spoke with about family violence in last 3 mos | ||
| 0 | reference | |
| 1–5 | 0.61 [0.44,0.86] | |
| 6+ | 0.41 [0.22,0.75] | |
| No. partners with strong tendency to drink alcohol before sex | ||
| 0 | reference | |
| 1 | 1.43 [0.91,2.25] | |
| 2+ | 1.87 [1.38,2.54] | |
Under the proportional odds assumption, the odds ratios apply to either of the two odds ratios being modeled – the odds ratio for forced sex by 2 or more partners relative to forced sex by one or less partners and the odds ratio for forced sex by any partner relative to forced sex by no partners. A significant interaction was found between unprotected sex with a non-spousal partner and alcohol consumption of the sex worker.
Full article at: http://goo.gl/Z1tmf1
By:
1Department of Epidemiology, Johns Hopkins
University Bloomberg School of Public Health, Baltimore, Maryland, USA
2YRG Centre for AIDS Research and
Education, Chennai, India
3Research Triangle Institute, Research
Triangle Park, North Carolina, USA
*Correspondence and request for reprints should
be addressed to: Vivian Go, PhD, Johns Hopkins University Bloomberg School of
Public Health, Infectious Diseases Program, Department of Epidemiology, 615
North Wolfe Street, Suite E-6610, Baltimore, Maryland 21205, USA, Fax:
1-410-955-1383, Tel: 1-410-614-4755
More at: https://twitter.com/hiv insight
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