Client-perpetrated and husband-perpetrated violence among female sex workers in Andhra Pradesh, India: HIV/STI risk across personal and work contexts

Elizabeth Reed, J T Erausquin, Allison K Groves, Marissa Salazar, Monica Biradavolu, Kim M Blankenship Sexually Transmitted Infections, 2017; Volume 92, Issue 6

In India, 2.4 million people are estimated to be living with HIV. While HIV prevalence is 0.25% among women in India, the prevalence among female sex workers (FSW) has been estimated at 5% and as high as 55% in select regions. The southern Indian state of Andhra Pradesh is among the Indian states with the highest rates of HIV; FSW are among the groups largely affected in this region.

This study examines violence experienced in work and personal contexts and relation to HIV risk factors in these contexts among female sex workers (FSW) in Andhra Pradesh, India.

The results show, perhaps for the first time, that violence perpetrated by husbands is associated with reduced condom use with clients, including accepting more money for sex without a condom. The link between client and husband perpetrated violence and accepting more money for unprotected sex provides some evidence for the possible contribution of economic factors in explaining the association between victimisation and increased HIV risk behaviours. 

Efforts are needed to address multiple forms of violence and perpetrators of violence in order to maximise HIV/STI prevention benefits.

Professor Kim Blankenship presented a STRIVE Learning Lab on defining and evaluating “structural” interventions, highly recommended as a reference.


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