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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.
BMC Public Health. 2016 07 29; 16:660.BP

Abstract

BACKGROUND

Female sex workers (FSWs) are at increased risk of HIV and STIs compared to women in the general population, and frequently experience violence in their working and domestic lives from a variety of perpetrators, which can enhance this risk. While progress has been made in addressing violence by police and clients, little work has been done to understand and prevent violence by intimate partners (IPs) among FSW populations.

METHODS

Samvedana Plus is a multi-level intervention programme that works with FSWs, their IPs, the sex worker community, and the general population, and aims to reduce violence and increase consistent condom use within these 'intimate' relationships. The programme involves shifting norms around the acceptability of beating as a form of discipline, challenging gender roles that give men authority over women, and working with men and women to encourage new relationship models based on gender equity and respect. The programme will aim to cover 800 FSWs and their IPs living in 47 villages in Bagalkot district, northern Karnataka. The study is designed to assess two primary outcomes: the proportion of FSWs who report: (i) physical or sexual partner violence; and (ii) consistent condom use in their intimate relationship, within the past 6 months. The evaluation will employ a cluster-randomised controlled trial design, with 50 % of the village clusters (n = 24) randomly selected to receive the intervention for the first 24 months and the remaining 50 % (n = 23) receiving the intervention thereafter. Statisticians will be blinded to treatment arm allocation. The evaluation will use an adjusted, cluster-level intention to treat analysis, comparing outcomes in intervention and control villages at midline (12 months) and endline (24 months). The evaluation design will involve quantitative and qualitative assessments with (i) all FSWs who report an IP (ii) IPs; and process/ implementation monitoring. Baseline data collection was completed in April 2015, and endline data collection is anticipated in May 2017.

CONCLUSIONS

This is an innovative intervention programme that aims to address violence by IPs as part of HIV prevention programming with FSWs. Reducing violence is expected to reduce vulnerability to HIV acquisition, and help women to work and live without fear of violence.

TRIAL REGISTRATION

Clinical Trials NCT02807259 Jun 24 2016 (retrospectively registered).

Authors+Show Affiliations

Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SN, UK. tara.beattie@lshtm.ac.uk.Karnataka Health Promotion Trust, Bangalore, India. University of Manitoba, Winnipeg, Canada.Karnataka Health Promotion Trust, Bangalore, India. University of Manitoba, Winnipeg, Canada.Karnataka Health Promotion Trust, Bangalore, India.Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SN, UK.Karnataka Health Promotion Trust, Bangalore, India.Karnataka Health Promotion Trust, Bangalore, India.Karnataka Health Promotion Trust, Bangalore, India. University of Manitoba, Winnipeg, Canada.Karnataka Health Promotion Trust, Bangalore, India.University of Manitoba, Winnipeg, Canada.Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SN, UK.Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SN, UK.University of Manitoba, Winnipeg, Canada.Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SN, UK.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

27473180

Citation

Beattie, Tara S., et al. "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." BMC Public Health, vol. 16, 2016, p. 660.
Beattie TS, Isac S, Bhattacharjee P, et al. 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. BMC Public Health. 2016;16:660.
Beattie, T. S., Isac, S., Bhattacharjee, P., Javalkar, P., Davey, C., Raghavendra, T., Nair, S., Ramanaik, S., Kavitha, D. L., Blanchard, J. F., Watts, C., Collumbien, M., Moses, S., & Heise, L. (2016). 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. BMC Public Health, 16, 660. https://doi.org/10.1186/s12889-016-3356-7
Beattie TS, et al. 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. BMC Public Health. 2016 07 29;16:660. PubMed PMID: 27473180.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Beattie,Tara S, AU - Isac,Shajy, AU - Bhattacharjee,Parinita, AU - Javalkar,Prakash, AU - Davey,Calum, AU - Raghavendra,T, AU - Nair,Sapna, AU - Ramanaik,Satyanarayana, AU - Kavitha,D L, AU - Blanchard,James F, AU - Watts,Charlotte, AU - Collumbien,Martine, AU - Moses,Stephen, AU - Heise,Lori, Y1 - 2016/07/29/ PY - 2016/02/03/received PY - 2016/07/22/accepted PY - 2016/7/31/entrez PY - 2016/7/31/pubmed PY - 2017/8/17/medline KW - Cluster Randomised Controlled Trial (RCT) KW - Condom use KW - Domestic violence KW - Female sex work KW - HIV KW - India KW - Intimate partner violence KW - STI KW - Violence SP - 660 EP - 660 JF - BMC public health JO - BMC Public Health VL - 16 N2 - BACKGROUND: Female sex workers (FSWs) are at increased risk of HIV and STIs compared to women in the general population, and frequently experience violence in their working and domestic lives from a variety of perpetrators, which can enhance this risk. While progress has been made in addressing violence by police and clients, little work has been done to understand and prevent violence by intimate partners (IPs) among FSW populations. METHODS: Samvedana Plus is a multi-level intervention programme that works with FSWs, their IPs, the sex worker community, and the general population, and aims to reduce violence and increase consistent condom use within these 'intimate' relationships. The programme involves shifting norms around the acceptability of beating as a form of discipline, challenging gender roles that give men authority over women, and working with men and women to encourage new relationship models based on gender equity and respect. The programme will aim to cover 800 FSWs and their IPs living in 47 villages in Bagalkot district, northern Karnataka. The study is designed to assess two primary outcomes: the proportion of FSWs who report: (i) physical or sexual partner violence; and (ii) consistent condom use in their intimate relationship, within the past 6 months. The evaluation will employ a cluster-randomised controlled trial design, with 50 % of the village clusters (n = 24) randomly selected to receive the intervention for the first 24 months and the remaining 50 % (n = 23) receiving the intervention thereafter. Statisticians will be blinded to treatment arm allocation. The evaluation will use an adjusted, cluster-level intention to treat analysis, comparing outcomes in intervention and control villages at midline (12 months) and endline (24 months). The evaluation design will involve quantitative and qualitative assessments with (i) all FSWs who report an IP (ii) IPs; and process/ implementation monitoring. Baseline data collection was completed in April 2015, and endline data collection is anticipated in May 2017. CONCLUSIONS: This is an innovative intervention programme that aims to address violence by IPs as part of HIV prevention programming with FSWs. Reducing violence is expected to reduce vulnerability to HIV acquisition, and help women to work and live without fear of violence. TRIAL REGISTRATION: Clinical Trials NCT02807259 Jun 24 2016 (retrospectively registered). SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/27473180/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_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3356-7 DB - PRIME DP - Unbound Medicine ER -