The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70284

Mary Jane Rotheram-Borus, PhD¹, Dallas Swendeman, MPH², Sung Jae Lee, MPH², Robert E. Weiss, PhD³, and Peter A Newman, PhD⁴. (1) Neuropsychiatric Institute, Center for Community Health, University of California, Los Angeles, 10920 Wilshire, Suite 350, Los Angeles, CA 90024-6521, (2) Center for Community Health, University of California, Los Angeles, 10920 Wilshire, Suite 350, Los Angeles, CA 90024-6521, 310-794-6144, metacom@ucla.edu, (3) Department of Biostatistics, UCLA, 51-269 CHS, Los Angeles, CA, CA 90095, (4) Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1A1, Canada

Background: The Sonagachi Project is an STD/HIV prevention program based in Kolkata, India. This multi-pronged intervention evolved in partnership with the sex-worker community and includes peer education, condom social marketing, community organizing, worker’s/human rights activism, micro-credit cooperative, and reproductive health care. HIV prevalence remains below 10% and condom use rates rose to 90% among sex-workers in Kolkata since 1992; the opposite trend occurred in other major Indian cities.

Method: The Sonagachi intervention was replicated in a “naïve” sex-worker community (“red-light area”) in North Bengal, India. In a control community a reproductive health clinic was established as standard care. One hundred sex-workers were recruited in each community and interviewed with structured questionnaires at baseline and three times over 18 months. Multivariate regression analyses were conducted to compare overall condom use rates, controlling for possible confounders. McNemar’s tests were used to evaluate changes in 100% condom use.

Results: Statistically significant increases in condom use were sustained in the intervention community (39%) compared to the control (11%). One hundred percent condom users increased a net 25% in the intervention community compared to a 16% net decrease in the control.

Conclusion: This study provides support for the efficacy of the Sonagachi model intervention in increasing condom use and maintaining low HIV prevalence among sex-workers.

Learning Objectives:

• Articulate the program’s development and six components designed to mitigate structural barriers and build on incentives to condom use.
• Recognize 3 ways researchers and community-based organizations can collaborate.
• Analyze the evaluation methods and results.
• Assess the efficacy of the intervention on condom use.

Keywords: HIV Interventions, Sex Workers

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.