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Strategies for reducing police arrest in the context of an HIV prevention programme for female sex workers: evidence from structural interventions in Karnataka, South India.
J Int AIDS Soc. 2016; 19(4 Suppl 3):20856.JI

Abstract

INTRODUCTION

Female sex workers (FSWs) frequently experience violence in their work environments, violating their basic rights and increasing their vulnerability to HIV infection. Structural interventions addressing such violence are critical components of comprehensive HIV prevention programmes. We describe structural interventions developed to address violence against FSWs in the form of police arrest, in the context of the Bill and Melinda Gates Foundation's India AIDS Initiative (Avahan) in Karnataka, South India. We examine changes in FSW arrest between two consecutive time points during the intervention and identify characteristics that may increase FSW vulnerability to arrest in Karnataka.

METHODS

Structural interventions with police involved advocacy work with senior police officials, sensitization workshops, and integration of HIV and human rights topics in pre-service curricula. Programmes for FSWs aimed to enhance collectivization, empowerment and awareness about human rights and to introduce crisis response mechanisms. Three rounds of integrated behavioural and biological assessment surveys were conducted among FSWs from 2004 to 2011. We conducted bivariate and multivariate analyses using data from the second (R2) and third (R3) survey rounds to examine changes in arrests among FSWs over time and to assess associations between police arrest, and the sociodemographic and sex work-related characteristics of FSWs.

RESULTS

Among 4110 FSWs surveyed, rates of ever being arrested by the police significantly decreased over time, from 9.9% in R2 to 6.1% in R3 (adjusted odds ratio (AOR) [95% CI]=0.63 [0.48 to 0.83]). Arrests in the preceding year significantly decreased, from 5.5% in R2 to 2.8% in R3 (AOR [95% CI]=0.59 [0.41 to 0.86]). FSWs arrested as part of arbitrary police raids also decreased from 49.6 to 19.5% (AOR [95% CI]=0.21 [0.11 to 0.42]). Certain characteristics, including financial dependency on sex work, street- or brothel-based solicitation and high client volumes, were found to significantly increase the odds of arrest for participants.

CONCLUSION

Structural interventions addressing police arrest of FSWs are feasible to implement. Based on our findings, the design of violence prevention and response interventions in Karnataka can be tailored to focus on FSWs, who are disproportionately vulnerable to arrest by police. Context-specific structural interventions can reduce police arrests, create a safer work environment for FSWs and protect fundamental human rights.

Authors+Show Affiliations

Karnataka Health Promotion Trust, Bangalore, India. Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.Karnataka Health Promotion Trust, Bangalore, India. Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada; ummcclar@myumanitoba.ca.Karnataka Health Promotion Trust, Bangalore, India. Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.Karnataka Health Promotion Trust, Bangalore, India. Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.Karnataka Health Promotion Trust, Bangalore, India.Karnataka Health Promotion Trust, Bangalore, India.Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27435708

Citation

Bhattacharjee, Parinita, et al. "Strategies for Reducing Police Arrest in the Context of an HIV Prevention Programme for Female Sex Workers: Evidence From Structural Interventions in Karnataka, South India." Journal of the International AIDS Society, vol. 19, no. 4 Suppl 3, 2016, p. 20856.
Bhattacharjee P, Isac S, McClarty LM, et al. Strategies for reducing police arrest in the context of an HIV prevention programme for female sex workers: evidence from structural interventions in Karnataka, South India. J Int AIDS Soc. 2016;19(4 Suppl 3):20856.
Bhattacharjee, P., Isac, S., McClarty, L. M., Mohan, H. L., Maddur, S., Jagannath, S. B., Venkataramaiah, B. K., Moses, S., Blanchard, J. F., & Gurnani, V. (2016). Strategies for reducing police arrest in the context of an HIV prevention programme for female sex workers: evidence from structural interventions in Karnataka, South India. Journal of the International AIDS Society, 19(4 Suppl 3), 20856. https://doi.org/10.7448/IAS.19.4.20856
Bhattacharjee P, et al. Strategies for Reducing Police Arrest in the Context of an HIV Prevention Programme for Female Sex Workers: Evidence From Structural Interventions in Karnataka, South India. J Int AIDS Soc. 2016;19(4 Suppl 3):20856. PubMed PMID: 27435708.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Strategies for reducing police arrest in the context of an HIV prevention programme for female sex workers: evidence from structural interventions in Karnataka, South India. AU - Bhattacharjee,Parinita, AU - Isac,Shajy, AU - McClarty,Leigh M, AU - Mohan,Haranahalli L, AU - Maddur,Srinath, AU - Jagannath,Sunitha B, AU - Venkataramaiah,Balasubramanya K, AU - Moses,Stephen, AU - Blanchard,James F, AU - Gurnani,Vandana, Y1 - 2016/07/18/ PY - 2015/12/13/received PY - 2016/04/11/revised PY - 2016/04/26/accepted PY - 2016/7/21/entrez PY - 2016/7/21/pubmed PY - 2017/10/17/medline KW - FSW KW - HIV prevention KW - HIV/AIDS KW - India KW - arrest KW - female sex worker KW - police KW - structural intervention KW - violence SP - 20856 EP - 20856 JF - Journal of the International AIDS Society JO - J Int AIDS Soc VL - 19 IS - 4 Suppl 3 N2 - INTRODUCTION: Female sex workers (FSWs) frequently experience violence in their work environments, violating their basic rights and increasing their vulnerability to HIV infection. Structural interventions addressing such violence are critical components of comprehensive HIV prevention programmes. We describe structural interventions developed to address violence against FSWs in the form of police arrest, in the context of the Bill and Melinda Gates Foundation's India AIDS Initiative (Avahan) in Karnataka, South India. We examine changes in FSW arrest between two consecutive time points during the intervention and identify characteristics that may increase FSW vulnerability to arrest in Karnataka. METHODS: Structural interventions with police involved advocacy work with senior police officials, sensitization workshops, and integration of HIV and human rights topics in pre-service curricula. Programmes for FSWs aimed to enhance collectivization, empowerment and awareness about human rights and to introduce crisis response mechanisms. Three rounds of integrated behavioural and biological assessment surveys were conducted among FSWs from 2004 to 2011. We conducted bivariate and multivariate analyses using data from the second (R2) and third (R3) survey rounds to examine changes in arrests among FSWs over time and to assess associations between police arrest, and the sociodemographic and sex work-related characteristics of FSWs. RESULTS: Among 4110 FSWs surveyed, rates of ever being arrested by the police significantly decreased over time, from 9.9% in R2 to 6.1% in R3 (adjusted odds ratio (AOR) [95% CI]=0.63 [0.48 to 0.83]). Arrests in the preceding year significantly decreased, from 5.5% in R2 to 2.8% in R3 (AOR [95% CI]=0.59 [0.41 to 0.86]). FSWs arrested as part of arbitrary police raids also decreased from 49.6 to 19.5% (AOR [95% CI]=0.21 [0.11 to 0.42]). Certain characteristics, including financial dependency on sex work, street- or brothel-based solicitation and high client volumes, were found to significantly increase the odds of arrest for participants. CONCLUSION: Structural interventions addressing police arrest of FSWs are feasible to implement. Based on our findings, the design of violence prevention and response interventions in Karnataka can be tailored to focus on FSWs, who are disproportionately vulnerable to arrest by police. Context-specific structural interventions can reduce police arrests, create a safer work environment for FSWs and protect fundamental human rights. SN - 1758-2652 UR - https://www.unboundmedicine.com/medline/citation/27435708/Strategies_for_reducing_police_arrest_in_the_context_of_an_HIV_prevention_programme_for_female_sex_workers:_evidence_from_structural_interventions_in_Karnataka_South_India_ L2 - https://doi.org/10.7448/IAS.19.4.20856 DB - PRIME DP - Unbound Medicine ER -