Changes in HIV & Syphilis Prevalence among Female Sex Workers from Three Serial Cross-Sectional Surveys in Karnataka State, South India

This paper examined trends over time in condom use, and the prevalences of HIV and syphilis, among female sex workers (FSWs) in South India.

7015 FSWs were interviewed over three rounds of surveys (round 1=2277; round 2=2387 and round 3=2351). Women who reported selling sex in exchange for money or gifts in the past month, and aged between 18 and 49 years, were included.

The surveys were conducted to monitor a targeted HIV prevention programme during 2004–2012. The main interventions included peer-led community outreach, services for the treatment and prevention of sexually transmitted infections, and empowering FSWs through community mobilisation.

• HIV prevalence declined significantly from rounds 1 to 3, from 19.6% to 10.8%; 
• High-titre syphilis prevalence declined from 5.9% to 2.4%. 
• Reductions were observed in most substrata of FSWs, although reductions among new sex workers, and those soliciting clients using mobile phones or from home, were not statistically significant. 
• Condom use ‘always’ with occasional clients 
• increased from 73% to 91%, 
• with repeat clients from 52% to 86% 
• and with regular partners from 12% to 30%. 
• Increased condom use was associated with exposure to the programme. However, condom use with regular partners remained low. 

The prevalences of HIV infection and high-titre syphilis among FSWs have steadily declined with increased condom use. Further reductions in prevalence will require intensification of prevention efforts for new FSWs and those soliciting clients using mobile phones or from home, as well as increasing condom use in the context of regular partnerships.

Full article at: http://goo.gl/UwNjWQ

By: Isac S1, Ramesh BM1, Rajaram S2, Washington R1, Bradley JE3, Reza-Paul S3, Beattie TS4, Alary M5, Blanchard JF3, Moses S3.

• 1Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada Karnataka Health Promotion Trust, Bangalore, Karnataka, India.
• 2Karnataka Health Promotion Trust, Bangalore, Karnataka, India.
• 3Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
• 4Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.
• 5Département de médecine sociale et préventive, Université Laval, Québec, Canada.  

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