There were statistically significant associations
between consistent condom use and certain
measures within each of the five domains in
bivariate analysis.
Identity and self-esteem
Sex workers' belief that sex work is like any
other work (OR 2.06; p=.000).
Autonomy and mobility
Being self-employed (OR 1.86; p=.000.)
Being able to take sick leave (OR 3.38;
p=.000).
Landlord doesn't interfere in household
activities (OR 2.69; p=.000).
Perception of reduced violence and
discrimination
Feels that violence toward sex workers has
decreased in recent years (OR 2.01; p=.000).
Feels that the rights of sex workers have
increased in recent years (OR 2.66; p=.000).
Access to and control over material
resources
Ownership of at least one of seven material
items (OR 2.51; p=.000).
Free access to more than one of three
household resources (OR 1.53; p=.032).
Social inclusion and community
participation
Being a member of a sex worker
organization (OR 1.45; p=.043).
Participation in community capacity building
seminars (OR 1.66; p=.024).
Voted freely in the last election (OR 1.75;
p=.002).
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Refining the response to HIV/AIDS
through global operations research
Sociodemographic and behavioral characteristics of
participating sex workers (N=512).
Variable Frequency and/or
Median &Range
Age 27.5 (16, 55)
Literate 37.7
No. of children: 1.0(0, 6)
Place of origin:
City of Calcutta 34.6
West Bengal state 41.7
Other states in India 8.4
Nepal 6.1
Bangladesh 9.2
No. of years as a sex worker 7.0 (0, 40)
Has a babu or regular partner 46.7
Always uses condoms with clients 61.1
Multivariate Model: significant determinants
of consistent condom use with clients
(N=503).
Variable Odds Ratio P-Value
(95% CI)
Has no children 1.77
(1.14, 2.73) .010
Not from West Bengal 2.80
(1.60, 4.86) .000
Landlord does not interfere 2.31
in all household activities (1.28, 4.20) .006
Voted freely in last election 1.76
(1.13, 2.73) .012
Ownership of at least 1.99
one material resource (1.18, 3.36) .010
Very comfortable talking 2.10
with peer educators (1.17, 3.76) .012
about personal problems
CHARACTERISTICS OF
THE SAMPLE
Nandinee Bandyopadhyay (Advisor DMSC), Sikha Das (DMSC),
Amitrajit Saha (DMSC), Smarajit Jana (CARE Bangladesh),
Vaishali Sharma Mahendra (Horizons/Population Council),
Johannes van Dam (Horizons/Population Council),
Deanna Kerrigan (Johns Hopkins School of Public Health)
Poster No. WePeE6557
50 Y E A R S1 9 5 2 - 2 0 0 2
The Role of Social Inclusion and
Community Development in
Reducing H IV/STI-related Vulnerability
Among Female Sex Workers
in Kolkata, India
Global interest is growing in community
development and social inclusion approaches
in HIV/AIDS prevention programming for sex
workers and other marginalized groups. Such
strategies go beyond individual-level behavior
change models to address the context within
which risk behavior takes place.
The Indian National AIDS Control
Organization and UNAIDS have designated
the Sonagachi Project in Kolkata, India, as a
“best practices” model for HIV/STI
prevention among female sex workers for its
use of community development approaches. A
collaborative study between the Durbar
Mahila Samanwaya Committee (DMSC), an
organization of sex workers that runs the
Sonagachi Project, and Horizons:
Examined the role and achievements of
community development strategies adopted
by the project.
Developed and tested indicators to
measure processes (e.g., social inclusion and
community participation) and outcomes (e.g.,
self-esteem, autonomy/mobility, freedom from
violence) of community development
interventions and to assess their relationship
to condom use.
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BACKGROUND AND
OBJECTIVES
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Formative, qualitative research in 11 red-
light districts covered by the project to identify
and generate questions on key domains.
Cross-sectional survey conducted with 512
brothel-based sex workers in the 11 red-light
areas.
Bivariate tests of association and
multivariate logistic regression to identify
significant predictors (P<.05) of consistent
condom use (CCU) among sex workers and
their clients.
METHODS
RESULTS
KEY FINDINGS
Longitudinal studies are needed to assess the
influence of community development
interventions on HIV/STI vulnerability among
sex worker over time. Such a study is currently
being conducted by PIM, SEPED, and Horizons
in Brazil.
NEXT STEPS
The average age of the sex workers was 27 years,
nearly two-thirds were illiterate, and more than
60% said they always used condoms with clients
(Table 1).
This case study of the Sonagachi
Project in Kolkata, India, found that
several key domains related to
community development are statistically
associated with consistent condom use
with all clients by female sex workers:
Identity and self-esteem
Autonomy and mobility
Perception of reduced violence and
discrimination
Access to and control over material
resources
Social inclusion and community
participation
This suggests that a community
development approach can be a useful
strategy for reducing HIV/STI-related
vulnerability among sex workers.
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DARBAR MAHILA SAMANWAYA COMMITTEE, INDIA
Funding for this study was provided by the U.S. Agency for International Development
The authors would like to thank Lsabelle de Zoysa, formely with Horizons,
for conceptuslizing the research study and contributing to the data analysis
