BMC Public Health | |
Female sex worker’s participation in the community mobilization process: two distinct forms of participations and associated contextual factors | |
Ramesh S Paranjape2  Sowmya Ramesh1  Sucheta Deshpande2  Mandar K Mainkar2  Seema Sahay2  Karikalan Nagarajan2  | |
[1] Population Council 1st Floor, 142 Golf Links, New Delhi 110003, India;National AIDS Research Institute- ICMR, 73, G Block, Pune, Bhosari 411026, India | |
关键词: India; Collective spaces; Public spaces; HIV; Empowerment; Community mobilization; Participation; Female Sex Workers; | |
Others : 1091187 DOI : 10.1186/1471-2458-14-1323 |
|
received in 2014-01-06, accepted in 2014-12-17, 发布年份 2014 | |
【 摘 要 】
Background
Community mobilization is a participatory intervention strategy used among Female Sex Workers (FSW's) to address HIV risks through behavior change and self empowerment. This study quantitatively measure and differentiate theoretically defined forms of FSW participation's and identify their contextual associated factors.
Method
Data was derived from cross-sectional Integrated Bio Behavioral Assessment conducted among FSW’s in Andhra Pradesh (AP) (n = 3370), Maharashtra (MH) (n = 3133) and Tamil Nadu (TN) (n = 2140) of India during 2009–2010. Information’s about socio-demography, community mobilization and participation experiences were collected. Conceptual model for two contexts of mobilization entailing distinct FSW participations were defined as participation in “collective” and “public” spaces respectively. Bivariate and multiple regression analysis were used.
Result
The level of participation in “collective” and “public” spaces was lowest in MH (43.9% & 11.7% respectively), higher in TN (82.2% & 22.5% respectively) and AP (64.7% & 33.1%). Bivariate and multivariate regression analysis highlighted the distinct nature of “participations” through their varied associations with FSW mobilization and background status.
In MH, street FSWs showed significantly lower collective participation (36.5%) than brothel FSWs (46.8%) and street FSWs showed higher public participation (16.2%) than brothel FSWs (9.7%). In AP both collective and public participation were significantly high among street FSWs (62.7% and 34.7% respectively) than brothel FSW’s (55.2% and 25.4% respectively).
Regression analysis showed FSWs with “community identity”, were more likely to participate in public spaces in TN and AP (AOR 2.4, 1.5-3.8 & AOR 4.9, CI 2.3-10.7) respectively. FSWs with “collective identity” were more likely to participate in collective spaces in TN, MH and AP (AOR 27.2 CI 13.7-53.9; AOR 7.3, CI 3.8-14.3; AOR 5.7 CI 3–10.9 respectively). FSWs exhibiting “collective agency” were more likely to participate in public spaces in TN, MH and AP (AOR 2.3 CI 1–3.4; AOR 4.5- CI 2.6-7.8; AOR 2.2 CI 1.5-3.1) respectively.
Conclusion
Findings reveal FSWs participation as a dynamic process inherently evolving along with the community mobilization process in match with its contexts. Participation in “Collective” and Public spaces” is indicators, symbolizing FSWs passage from the disease prevention objectives towards empowerment, which would help better understand and evaluate community mobilization interventions.
【 授权许可】
2014 Nagarajan et al.; licensee BioMed Central.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150128170134525.pdf | 530KB | download | |
Figure 2. | 63KB | Image | download |
Figure 1. | 67KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
【 参考文献 】
- [1]Kerrigan D, Telles P, Torres H, Overs C, Castle C: Community development and HIV/STI-related vulnerability among female sex workers in Rio de Janeiro, Brazil. Health Educ Res 2008, 23(1):137-145.
- [2]Avahan 2005: India AIDS Initiative [https://docs.gatesfoundation.org/Documents/avahan_hivprevention.pdf webcite]. Last accessed on, December 2013
- [3]Galavotti C, Wheeler T, Kuhlmann AS, Saggurti N: Navigating the swampy lowland: a framework for evaluating the effect of community mobilisation in female sex workers in Avahan, the India AIDS Initiative. J Epidemiol Community Health 2012, 66:ii9-ii15.
- [4]KHPT: Community mobilization of female sex workers: Module 2 a Strategic Approach to Empower Female Sex Workers in Karnataka KHPT. [http://strive.lshtm.ac.uk/system/files/attachments/KHPT%20Evaluation%20of%20Community%20Mobilization.pdf webcite]. Last accessed on, December 2013
- [5]Blankenship KM, West BS, Kershaw TS, Biradavolu MR: Power, community mobilization, and condom use practices among female sex workers in Andhra Pradesh, India. AIDS 2008, 22(Suppl5):S109-S116.
- [6]Cornish FE: Constructing an actionable environment: Collective action for HIV prevention among Kolkata sex workers. London: School of Economics and Political Science; 2004. URL [http://etheses.lse.ac.uk/44/ webcite] Last accessed on December, 2013
- [7]Morgan L: Community participation in health: perpetual allures, persistent challenge. Health Pol Plan 2001, 16(3):221-230.
- [8]Basu A, Dutta MJ: Sex workers and HIV/AIDS: analyzing participatory culture-centered health communication strategies. Hum Commun Res 2009, 35:86-114.
- [9]STI: Emerging results from a scaled HIV prevention program–Avahan, the India AIDS Initiative. Sex Transm Infect 2010, 86(1):i76-i82.
- [10]Cornish FE: Empowerment to participate: a case study of participation by Indian sex workers in HIV prevention. J Community Appl Soc Psychol 2006, 16:301-315.
- [11]Avahan 2008: India AIDS Initiative URL [https://docs.gatesfoundation.org/Documents/Avahan_HIVPrevention.pdf webcite] last accessed on September 2014
- [12]Saidel T, Adhikary R, Mainkar M, Dale J, Loo V, Rahman M, Ramesh BM, Paranjape RS: Baseline integrated behavioural and biological assessment among most at-risk populations in six high-prevalence states of India: design and implementation challenges. AIDS 2008, 22(Suppl 5):S17-S34.
- [13]Parimi P, Mishra RM, Tucker S, Saggurti N: Mobilising community collectivisation among female sex workers to promote STI service utilisation from the government healthcare system in Andhra Pradesh, India. J Epidemiol Community Health 2012, 66(Suppl 2):ii62-ii68.
- [14]Swendeman D, Basu I, Das S, Jana S, Rotheram-Borus MJ: Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases. Soc Sic Med 2009, 69(8):1157-1166.
- [15]Perez D, Lefe`vre P, Romero ML, Sanchez L, Pol PD Stuyft PV: Augmenting frameworks for appraising the practices of community based health interventions. Health Pol Plan 2009, 24:335-341.
- [16]United Nations: United Nations Declaration on the Elimination of Violence against Women. URL [http://www.un.org/documents/ga/res/48/a48r104.htm webcite] last accessed on December 2013
- [17]WHO: Addressing violence against sex workers. URL [http://www.who.int/hiv/pub/sti/sex_worker_implementation/swit_chpt2.pdf webcite] last accessed on September 2014
- [18]IBBA: Integrated Behavioral and Biological Assessment. [http://www.ibbainfo.in/reports.php webcite]. Last accessed on September 2014
- [19]Samuels F, Pelto P, Verma R, George CK: Social Capital and HIV Risk Behavior among Female Sex Workers and Men Who Have Sex with Men in Andhra Pradesh: Insights From Quantitative and Qualitative Data. Washington, DC: Population Council; 2006.
- [20]Chakravarthy JBR, Joseph SV, Pelto P, Kovvali D: Community mobilisation programme for female sex workers in coastal Andhra Pradesh, India: processes and their effects. J Epidemiol Community Health 2012, 66:ii78-ii86.
- [21]World Bank: Self Help Groups empower 8 million women in Andhra Pradesh. [http://web.worldbank.org/WBSITE/EXTERNAL/NEWS/0,,contentMDK:21249032~pagePK:64257043~piPK:437376~theSitePK:4607,00.html webcite]. Last accessed on September 2014
- [22]Thomas K: Andhra Pradesh Community Self Help Model. Centre for Good Governance Collected Working Papers Vol 2. 2003. [http://www.cgg.gov.in/publicationdownloads2a/Volume%202.pdf webcite] Last accessed on December 2013
- [23]Fernandez AP: History and spread of the self-help affinity group movement in India. The role played by IFAD. 2007. [MYRADA occasional papers] [http://www.ifad.org/operations/projects/regions/pi/paper/3.pdf webcite] last accessed on December 2013
- [24]Asthana S, Oostvogels R: Community participation in HIV prevention: problems and prospects for community-based strategies among female sex workers in Madras. Soc Sci Med 1996, 4:133-148.
- [25]Cornish F, Ghosh R: The necessary contradictions of ‘community-led’ health promotion: a case study of HIV prevention in an Indian red light district. Soc Sci Med 2007, 64:496-507.
- [26]Cornish F, Campbell C: The social conditions for successful peer education: a comparison of two HIV prevention programs run by sex workers in India and South Africa. At J Community Psychol 2009, 44:123-135.
- [27]Abel G, Fitzgerald L, Brunton C: The Impact of the Prostitution Reform Act on the Health and Safety Practices of Sex Workers. Christchurch, NZ: University of Otago; Last Accessed on September 15 [http://www.otago.ac.nz/christchurch/otago018607.pdf webcite]
- [28]NACO: Targeted interventions under NACP III: Operational guidelines volume I––core high risk groups. New Delhi, India: National AIDS Control Organization (NACO); 2007.
- [29]Punyam S, Pullikalu RS, Mishra RM, Sandri P, Mutupuru BP, Kokku SB, Parimi P: Community advocacy groups as a means to address the social environment of female sex workers: a case study in Andhra Pradesh, India. J Epidemiol Community Health 2012, 66(Suppl_2):ii87.
- [30]Biradavolu MR, Burris S, George A, Jena A, Blankenship KM: Can sex workers regulate police? Learning from an HIV prevention project for sex workers in southern India. Soc Sci Med 2009, 68(8):1541-1547.
- [31]Tedrow VA, Zelaya CE, Kennedy CE, Morin SF, Khumalo-Sakutukwa G, Sweat MD, Celentano DD: No ‘magic bullet’: exploring community mobilization strategies used in a multi-site community based randomized controlled trial: Project Accept (HPTN 043). AIDS Behav 2012, 16(5):1217-1226.
- [32]Sumartojo E, Doll L, Holtgrave D, Gayle H, Merson M: Enriching the mix: incorporating structural factors into HIV prevention. AIDS 2010, Suppl 1:S1-S2.
- [33]Rotheram-Borus MJ, Swendeman D, Chovnick G: The past, present, and future of HIV prevention: integrating behavioral, biomedical, and structural intervention strategies for the next generation of HIV prevention. Annu Rev Clin Psychol 2009, 5:143-167.
- [34]Blankenship KM, Burroway R, Reed E: Factors associated with awareness and utilisation of a community mobilisation intervention for female sex workers in Andhra Pradesh, India. Sex Transm Infect 2010, 86(Suppl_1):i69-i75.