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