305316
Determinants of consistent condom use among sex workers in India: Testing competing hypotheses of perceived risk, empowerment, and financial security
Methods: A household survey was conducted with a random sample of sex workers (n=200) in two red light districts in Kolkata, India. Logistic regression was used to assess predictors of condom use with occasional clients, regular clients, intimate live-in partners, husbands, and all partners combined.
Results: Financial security significantly increases the odds of using a condom with all partner types. Feeling susceptible to HIV (perceived risk), serving as a peer educator (empowerment), and participating in a door-to-door campaign to teach other sex workers about condoms (empowerment) significantly increases odds of using a condom with regular clients, intimate partners, and husbands but not with occasional clients.
Conclusions: The findings demonstrate the importance of financial security for predicting consistent condom use between sex workers and all partner types. Risk perceptions and empowerment become more important predictors of condom use as the level of intimacy and regularity of interaction between sex worker and partner increases. Interventions to improve consistent condom use among sex workers should utilize strategies specific to each type of partner rather than employing a one-size-fits-all approach.
Learning Areas:
Occupational health and safetyPublic health or related education
Public health or related public policy
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Evaluate competing hypotheses for predicting condom use among sex workers.
Define the "intimacy gradient" guiding condom use behaviors among sex workers across partner types.
Describe a community-based structural intervention that acts on multiple levels to improve the health and social status of sex workers in India.
Keyword(s): Sex Workers, Women and HIV/AIDS
Qualified on the content I am responsible for because: I am a Ph.D. student with over ten years of research experience in sexual health. I conducted fieldwork with the sex work community who provided qualitative and quantitative data for this study. I have also worked as a women's rights activist in post-colonial and critical race feminist movements.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.