Population Council Research that makes a difference

XVIII International AIDS Conference (AIDS 2010)
18–23 July 2010

Abstract

"Exploring linkage between violence and reproductive, HIV risks among female sex workers on the move in India"
Suvakant N. Swain, Niranjan Saggurti, Ravi Verma, and Anrudh Jain

Background
Female sex workers (FSWs) are the most affected population by the HIV epidemic within India and elsewhere. Despite research and programmatic attention to FSWs, little is known concerning sex workers' reproductive and HIV risks in relation to their experiences of violence. The current study assesses the prevalence of violence, and its association with reproductive and HIV risks among a group of mobile FSWs from four high HIV-prevalence states of India.

Methods
A cross-sectional survey was conducted across four states in 2006–07. Analyses were limited to 5,498 mobile FSWs who moved to at least two different places for sex work. Analyses calculated the prevalence of past-year experience of different types of violence. Adjusted logistic regression models were used to examine the association between violence and reproductive and HIV risks after controlling for several background characteristics and program exposure.

Results
One-third of the total mobile FSWs experienced violence. Physical violence was reported by 11 percent of the total sample, and 19.5 percent reported sexual violence. Those who experienced violence in general were significantly more likely to also report a higher number of pregnancies (adjusted odds ratio [AOR] = 1.2, 95% CI=1.0–1.6), to have ever lost a pregnancy (31.1% vs. 24.5%; AOR = 1.4, 95% CI=1.2–1.6), ever experienced forced termination of pregnancy (AOR = 2.4, 95% CI=2.0–2.7), or experienced multiple forced termination of pregnancies (AOR = 2.2, 95% CI=1.7–2.8). Further, women who experienced sexual violence were significantly more likely to report HIV risk (inconsistent condom use: AOR = 1.8, 95%CI: 1.4–2.3) than the women who experienced physical violence only.

Conclusions
Pervasiveness of violence and its strong association with reproductive health and HIV risks show the need for violence prevention interventions among FSWs in India. Existing community mobilization programs focused on empowerment of FSWs should broaden efforts to identify violent environments within localities and devise suitable interventions for the perpetuators.

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