STRIVE Tackling the structural drivers of HIV

Violence in the intimate relationships of female sex workers increases their vulnerability to HIV/AIDS. An intervention and evaluation study in northern Karnataka, India, Samvedana Plus seeks to understand and address this form of violence and HIV risk.

Context

KHPT’s decade-long work organising sex worker collectives has succeeded in reducing violence against sex workers from clients, police and gangs. But sex workers continue to experience violence in their intimate relationships with lovers or husbands. This form of violence:

• causes pain and injury, and violates the women’s right to safety
• can cause condom breakage
• can make it difficult for women to negotiate condom use

Implementation

KHPT is implementing Samvedana Plus:

• with 800 female sex workers and
 their intimate partners
• in partnership with Chaitanya AIDS Tadegattuwa Mahila Sangha, a community-based organisation (CBO) of sex workers
• in Bagalkot District in northern Karnataka

The programme and study will run from 2015 to 2017. The design includes successful strategies piloted with support from the Bill & Melinda Gates Foundation and the United Nations Trust Fund to End Violence against Women (UNTF).

Samvedana Plus intervenes with men who are violent, women who face abuse and the wider society. It aims to:

• change disempowering gender norms 

• reduce violence 

• increase condom use among sex workers in their intimate partnerships 
 

The UNTF, What Works to Prevent Violence against Women and Girls consortium and the University of Manitoba, Canada support the intervention.

Study

STRIVE partners KHPT and LSHTM are working together to evaluate the programme. The study:

• investigates the relationship between social norms and HIV risk in the context of sex workers’ intimate partnerships
• assesses the efficacy of the intervention in modifying these norms
• sharpens understanding of the structural drivers of HIV transmission

Resources

Publications

• A community-based qualitative study on the experience and understandings of intimate partner violence and HIV vulnerability from the perspectives of female sex workers and male intimate partners in North Karnataka state, India
• Understanding the Relationship Between Female Sex Workers and Their Intimate Partners: Lessons and Initial Findings From Participatory Research in North Karnataka, South India
• Violence experience by perpetrator and associations with HIV/STI risk and infection: a cross-sectional study among female sex workers in Karnataka, south India
• Intervening in masculinity: work, relationships and violence among the intimate partners of female sex workers in South India
• Dutiful daughters: HIV/AIDS, moral pragmatics, female citizenship and structural violence among Devadasis in northern Karnataka, India
• Reducing violence and increasing condom use in the intimate partnerships of female sex workers: study protocol for Samvedana Plus, a cluster randomised controlled trial in Karnataka state, south India
• Pursuing authenticity from process to outcome in a community-based participatory research study of intimate partner violence and HIV vulnerability in north Karnataka, India
• Intimate relationships of Devadasi sex workers in south India: An exploration of risks of HIV/STI transmission
• Fertility intentions, power relations and condom use within intimate and other non-paying partnerships of women in sex work in Bagalkot District, South India

Reports

• Understanding the relationship between sex workers and their intimate partners: Findings from participatory research in North Karnataka, India - research report
• Stigma and discrimination among female sex workers: Learnings from a pilot project in north Karnataka, India - technical report
• Reducing intimate partner violence against female sex workers: findings from the Samvedana Plus baseline study - technical report

Implementation briefs

• Intimate partners learn about healthy masculinity
• Community programmes raise awareness of violence against women
• Working with Community-based Organisations
• Female sex workers resist violence from intimate partners

Evidence briefs

• Masculinities, gender norms and intimate partner violence affecting female sex workers
• Uncovering the roots of intimate partner violence
• Samvedana Plus: Reducing Violence and Increasing Condom Use in the Intimate Partnerships of Female Sex Workers in Bagalkote District, North Karnataka, South India

Posters and presentations

• Understanding masculinities, gender norms and intimate partner violence in men's intimate relationships with female sex workers of Northern Karnataka - poster
• A community-based qualitative study to explore the experience and understandings of intimate partner violence among women in sex work and their intimate partners in north Karnataka, India - poster
• Using peer group reflection to empower sex workers to reduce violence and increase condom use with their intimate partner relationships - poster presented at ICAAP
• Mental health mediates violence and condom use among women in sex work with intimate partners in Karnataka, India - poster presented at ICAAP
• Role of intensive strategies to address stigma and discrimination among female sex workers - poster presented at ICAAP
• Forms of intimate partner violence and associated HIV risk and vulnerability among women in sex work in Karnataka, India - presentation
• Findings from Samvedana Plus: a multi-level intervention to increase condom use and reduce violence among sex workers in Karnataka - webinar

Programme tools

• Reducing IPV and increasing condom usage in the HIV STI response - A Facilitator's Guide for training female sex workers
• Reducing intimate partner violence and increasing condom usage in the HIV STI response - A Facilitator's Guide for training intimate partners of female sex workers 

Infographics

• Empowering sex workers: Preventing violence - infographic for Orange Day 2015

Other resources

• Samvedana Plus brochure
• Samvedana Plus Implementation Design
• Uncovering the roots of intimate partner violence: A qualitative inquiry with female sex workers and intimate partners in northern Karnataka - research update
• Masculinities, gender norms and intimate partner violence affecting female sex workers - research update

Related project

Community mobilisation among sex worker collectives