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Document 0305
DOCN M9650305
TI Impact of an intervention on HIV, sexually transmitted diseases, and
condom use among sex workers in Bombay, India.
DT 9605
AU Bhave G; Lindan CP; Hudes ES; Desai S; Wagle U; Tripathi SP; Mandel JS;
AIDS Surveillance Center, Department of Microbiology, Seth G.S.; Medical
College, Bombay, India.
SO AIDS. 1995 Jul;9 Suppl 1:S21-30. Unique Identifier : AIDSLINE
MED/96085740
AB OBJECTIVE: To develop and test an HIV intervention targeting sex workers
and madams in the brothels of Bombay. SUBJECTS AND METHODS: In a
controlled intervention trial, with measurements before and after the
intervention, 334 sex workers and 20 madams were recruited from an
intervention site, and 207 and 17, respectively, from a similar control
site, both in red-light areas of Bombay. All sex workers were tested for
antibodies to HIV and syphilis, and for hepatitis B surface antigen.
Information on sexual practices, condom use and knowledge of HIV was
collected by interviewer-administered questionnaire. All subjects in the
intervention group underwent a 6-month program of educational videos,
small group discussions and pictorial educational materials; free
condoms were also distributed. The blood tests and the questionnaire
were readministered to all subjects at both sites immediately after the
intervention. Both groups were followed for approximately 1 year.
RESULTS: The baseline level of knowledge about HIV and experience with
condoms was extremely low among both sex workers and madams. The
baseline prevalence of HIV antibodies was 47% in the intervention group
and 41% in the control group (P = 0.17). The incidence densities for HIV
and sexually transmitted diseases were significantly different in the
two groups (all P < 0.005): 0.05 and 0.16 per person-year of follow-up
for HIV, 0.08 and 0.22 per person-year for antibodies to syphilis, and
0.04 and 0.12 per person-year for hepatitis B surface antigen in the
intervention and control women, respectively. Following the
intervention, women reported increased levels of condom use, and some
(41%) said they were willing to refuse clients who wouldn't use them.
However, both the sex workers and the madams were concerned about losing
business if condom use was insisted upon. CONCLUSIONS: Both HIV
prevalence and incidence are alarmingly high among female sex workers in
Bombay. Successful interventions can be developed for these women, and
even a partial increase in condom use may decrease the transmission of
HIV and sexually transmitted diseases. Intervention programs of longer
duration that target madams and clients and make condoms easily
available are urgently needed at multiple sites in red-light areas.
DE Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/*PREVENTION &
CONTROL/TRANSMISSION Adolescence Adult Audiovisual Aids
Condoms/*STATISTICS & NUMER DATA Cross-Sectional Studies *Developing
Countries Female Follow-Up Studies *Health Education Hepatitis
B/EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION Human Incidence
India/EPIDEMIOLOGY Knowledge, Attitudes, Practice Middle Age
Prostitution/*STATISTICS & NUMER DATA Risk Factors Sexually
Transmitted Diseases/EPIDEMIOLOGY/*PREVENTION & CONTROL/ TRANSMISSION
Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S.
Syphilis/EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION Urban
Population/*STATISTICS & NUMER DATA CLINICAL TRIAL JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).