Abstract
Background/ObjectiveThe Pragati programme is an on-going empowerment programme for female sex workers (FSWs) working and living in Bangalore, India. Pragati aims to reduce transmission of HIV and sexually transmitted infections (STIs) among FSWs. This study describes the STI incidence rate, contact rate, and condom use during follow-up years.DesignBetween April 2005 and November 2010, 20,330 FSWs participated in the programme. Outcome measures were programme exposure (number of contacts per person-year), STI incidence rate, and condom use. All analyses were stratified by year of follow-up. STIs were diagnosed by syndromic case management in either programme or referral clinics. We restricted our analyses to the period between April 2005 and July 2008 (when the majority of STIs were diagnosed in programme clinics), in order to minimise the possible influence of differences in STI diagnosis between clinic types.ResultsResults showed a significant increase of programme exposure (p-value for trend < 0.001) and a significant decrease in the STI incidence rate (p-value for trend < 0.001) over the follow-up time (between April 2005 and July 2008). Reported condom use at last paid sex increased from 77.6% in year 1 to 100% in year 4 of follow-up (p-value for trend < 0.001).ConclusionOur data seem to suggest that the Pragati programme had a positive effect on the STI incidence rate and condom use, possibly as a result of increased programme exposure. We recommend for future studies to invest more in the study design, type of data collection, and recording mechanisms before starting with an intervention. Incorporation of empowerment strategies as an approach in HIV prevention programmes can have a beneficial effect on the lives and livelihoods of FSWs.
Highlights
Background/Objective: The Pragati programme is an on-going empowerment programme for female sex workers (FSWs) working and living in Bangalore, India
sexually transmitted infections (STIs) diagnosis was based on the same protocol (SCM) in both clinic types, the proportion of visits during which an STI was diagnosed was significantly higher in referral clinics (59.5%) compared to programme clinics (29.4%) (Fig. 1C)
Our study shows that the FSWs participating in the Pragati programme had a significant increase of programme exposure, used more condoms, and showed a significant decrease in STI incidence rate during a relatively short follow-up period
Summary
Background/Objective: The Pragati programme is an on-going empowerment programme for female sex workers (FSWs) working and living in Bangalore, India. Reduced prevalence rates of STIs, high programme exposure coinciding with increasing condom use, declining syphilis rates, and stabilising HIV prevalence were reported [12] Both above-mentioned studies are behavioural change interventions which address a broad range of FSW-related problems. The empowerment strategy in the Pragati programme includes a crisis response team, a microfinance system, a de-addiction programme, condom use promotion, STI prevention and detection (with the use of syndromic case management, or SCM), and the provision of rest places (to douche, relax, and meet peers) This so-called empowerment strategy is a holistic approach which includes all relevant factors that play an important role in the HIV epidemic affecting FSWs and the FSW community in Bangalore.
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