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Exposure to HIV prevention programmes associated with improved condom use and uptake of HIV testing by female sex workers in Nagaland, Northeast India.
BMC Public Health. 2013 May 15; 13:476.BP

Abstract

BACKGROUND

There a concentrated HIV epidemic among female sex workers (FSWs) in the state of Nagaland, located in the north-east of India. Local non-government organisations (NGOs) are supported by the National State AIDS Control Society (NSACS) and the Avahan-funded Project ORCHID (Avahan is the India AIDS initiative of Bill & Melinda Gates Foundation in India) to deliver a range of interventions to FSWs including safe sex promotion, condom distribution, and testing and treatment of sexually transmitted infections (STIs). The commercial hub of Nagaland, Dimapur, is an important transportation node, and hosts a concentration of FSWs. This paper reports on comparative analysis of Integrated Behavioural and Biological Assessment (IBBA) data collected from FSWs in Dimapur in 2006 and 2009 to assess changes in condom use, HIV testing, and exposure to interventions.

METHODS

Two IBBA cross-sectional surveys were undertaken among FSWs in Dimapur in 2006 (Round 1) and 2009 (Round 2) using an interviewer-administered questionnaire and the collection of blood and urine samples. Respondent-driven sampling (RDS), a sampling technique for use among hidden populations, was used to recruit the samples.

RESULTS

When round 1 is compared with round 2, there was a marked and statistically significant improvement in the use of condoms at last sex with both occasional (35.2% to 72.4%) and regular (25.8% to 57.7%) clients, and an increase in the proportion having ever had an HIV test (8.9% to 29.1%). There was no evidence of an improvement in the proportional coverage of the HIV prevention services delivered to FSWs in Dimapur between round 1 and round 2. In round 2, FSWs exposed to the programme were more than twice (OR=2.27) as likely to consistently use condoms with occasional clients, four times (OR: 4.11) more likely to use condoms consistently with regular clients and nine times (OR: 9.08) more likely to have ever had an HIV test.

CONCLUSIONS

We found evidence of an increase in condom use and HIV testing, and a strong and consistent association between programme exposure and condom use and HIV testing indicating that NGO HIV prevention programmes have been making a substantial contribution to HIV prevention among FSWs in Dimapur. However, there was no evidence of improved coverage of HIV prevention services, and there is a clear need to expand the reach of services in order for them to have an impact on a larger pool of FSWs.

Authors+Show Affiliations

Nossal Institute for Global Health, University of Melbourne, Victoria, Australia. g.armstrong@unimelb.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23675685

Citation

Armstrong, Gregory, et al. "Exposure to HIV Prevention Programmes Associated With Improved Condom Use and Uptake of HIV Testing By Female Sex Workers in Nagaland, Northeast India." BMC Public Health, vol. 13, 2013, p. 476.
Armstrong G, Medhi GK, Kermode M, et al. Exposure to HIV prevention programmes associated with improved condom use and uptake of HIV testing by female sex workers in Nagaland, Northeast India. BMC Public Health. 2013;13:476.
Armstrong, G., Medhi, G. K., Kermode, M., Mahanta, J., Goswami, P., & Paranjape, R. (2013). Exposure to HIV prevention programmes associated with improved condom use and uptake of HIV testing by female sex workers in Nagaland, Northeast India. BMC Public Health, 13, 476. https://doi.org/10.1186/1471-2458-13-476
Armstrong G, et al. Exposure to HIV Prevention Programmes Associated With Improved Condom Use and Uptake of HIV Testing By Female Sex Workers in Nagaland, Northeast India. BMC Public Health. 2013 May 15;13:476. PubMed PMID: 23675685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exposure to HIV prevention programmes associated with improved condom use and uptake of HIV testing by female sex workers in Nagaland, Northeast India. AU - Armstrong,Gregory, AU - Medhi,Gajendra K, AU - Kermode,Michelle, AU - Mahanta,Jagadish, AU - Goswami,Prabuddhagopal, AU - Paranjape,Rs, Y1 - 2013/05/15/ PY - 2012/10/19/received PY - 2013/05/10/accepted PY - 2013/5/17/entrez PY - 2013/5/17/pubmed PY - 2014/4/11/medline SP - 476 EP - 476 JF - BMC public health JO - BMC Public Health VL - 13 N2 - BACKGROUND: There a concentrated HIV epidemic among female sex workers (FSWs) in the state of Nagaland, located in the north-east of India. Local non-government organisations (NGOs) are supported by the National State AIDS Control Society (NSACS) and the Avahan-funded Project ORCHID (Avahan is the India AIDS initiative of Bill & Melinda Gates Foundation in India) to deliver a range of interventions to FSWs including safe sex promotion, condom distribution, and testing and treatment of sexually transmitted infections (STIs). The commercial hub of Nagaland, Dimapur, is an important transportation node, and hosts a concentration of FSWs. This paper reports on comparative analysis of Integrated Behavioural and Biological Assessment (IBBA) data collected from FSWs in Dimapur in 2006 and 2009 to assess changes in condom use, HIV testing, and exposure to interventions. METHODS: Two IBBA cross-sectional surveys were undertaken among FSWs in Dimapur in 2006 (Round 1) and 2009 (Round 2) using an interviewer-administered questionnaire and the collection of blood and urine samples. Respondent-driven sampling (RDS), a sampling technique for use among hidden populations, was used to recruit the samples. RESULTS: When round 1 is compared with round 2, there was a marked and statistically significant improvement in the use of condoms at last sex with both occasional (35.2% to 72.4%) and regular (25.8% to 57.7%) clients, and an increase in the proportion having ever had an HIV test (8.9% to 29.1%). There was no evidence of an improvement in the proportional coverage of the HIV prevention services delivered to FSWs in Dimapur between round 1 and round 2. In round 2, FSWs exposed to the programme were more than twice (OR=2.27) as likely to consistently use condoms with occasional clients, four times (OR: 4.11) more likely to use condoms consistently with regular clients and nine times (OR: 9.08) more likely to have ever had an HIV test. CONCLUSIONS: We found evidence of an increase in condom use and HIV testing, and a strong and consistent association between programme exposure and condom use and HIV testing indicating that NGO HIV prevention programmes have been making a substantial contribution to HIV prevention among FSWs in Dimapur. However, there was no evidence of improved coverage of HIV prevention services, and there is a clear need to expand the reach of services in order for them to have an impact on a larger pool of FSWs. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/23675685/Exposure_to_HIV_prevention_programmes_associated_with_improved_condom_use_and_uptake_of_HIV_testing_by_female_sex_workers_in_Nagaland_Northeast_India_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-476 DB - PRIME DP - Unbound Medicine ER -