Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

XIV International AIDS Conference

Abstracts WePeE6557-WePeE6560 223

Presenting author: Adele Weiner, Wurzweiler School of Social Work, Yeshiva
University, 500 West 185th Street, New York City, NY 10033, United States, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
WePeE6557 Assessing the contribution of social inclusion and
community development in reducing
HIV/STI-related vulnerability among female sex
workers in Kolkata, India
N. Bandopadhyay1, S. Das, A. Saha1, S. Jana2, V. Sharma Mahendra3, J. van
Dam4, D. Kerrigan5. 1Durbar Mahila Samanwaya Committee, Population
Council/Horizons Program, 53 Lodi Estate, New Delhi, 110 003, India; 2CARE
Dhaka, Dhaka, Bangladesh; 3Population Council/Horizons Program, New Delhi,
India; 4Population Council/Horizons Program, Washington, DC, United States;
5Johns Hopkins University, Baltimore, United States
Background: There is a growing consensus that reducing HIV/STI-related vulnerability, especially among marginalized groups such as female sex workers
(SW), requires innovative strategies that go beyond individual-level behavior
change models, such as the promotion of social inclusion and community development. However, little research has been conducted on how to measure these
constructs and assess their contribution to HIV-related outcomes.
Methods: Formative qualitative research was conducted in 12 red-light districts
covered by the 'Sonagachi Project' in Kolkata, India to generate questions on five
key related domains: identity and self-esteem, autonomy and mobility, violence
and discrimination, access to and control over material resources, and social
and democratic participation. A cross-sectional survey was conducted with 512
brothel-based sex workers. Bivariate tests of association and logistic regression
were conducted to identify significant (p<.05) predictors of consistent condom
use (CCU) among sex workers and clients.
Results: The following are examples from each of the five domains of variables
associated with CCU: (1) SW belief that sex work is like any other work (OR 2.06);
(2) Being able to take sick leave (OR 3.38); (3) Feeling that violence towards SW
has decreased in recent years (OR 2.01); (4) having access and control over material resources (OR 2.51); (5) Being a member of a SW organization (OR 1.45)
and having voted freely in the last election (OR 1.75).
Conclusions: Several elements of community development are statically associated with consistent condom use in cross-sectional analyses. Longitudinal studies are needed to assess the influence of changes in community development on
HIV/STI vulnerability among SW over time.
Presenting author: Nandinee Bandopadhyay, Population Council/Horizons Program, 53 Lodi Estate, New Delhi, 110003, India, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeE6558 The influence of relationship intimacy on
consistent condom use in the context of female
sex work
L. Moreno', D. Kerrigan2, S. Rosario1, J. Ellen3, M. Sweat4. 1COIN, 615 N
Wolfe St E7141, Baltimore MD 21205, Dominican Republic; 2Johns Hopkins,
Baltimore MD, United States; 3Johns Hopkins SOM, Baltimore MD, United
States; 4Johns Hopkins SPH, Baltimore MD, United States
Background: Prior research has often dichotomized the sexual relationships of
female sex workers (SWs) into two categories: paying clients in the public domain
of the street and non-paying steady partners in private domain of the home. Recent research has revealed that within the context of commercial sex, SWs may
have a variety of paying partner types, ranging in levels of perceived relationship
intimacy. This study developed a culturally appropriate scale for relationship intimacy in the context of female sex work based on qualitative research and tested
its statistical association with consistent condom use (CCU) among SWs and
regular paying partners in Dominican Republic.
Methods: 306 SW and 308 regular paying partners participated in a crosssectional survey. Multivariate logistic regression was conducted to determine the
association between relationship intimacy and consistent condom use (CCU)
controlling for socio-demographic factors.
Results: 60.1% of SW and 61.5% of clients reported always using a condom with
their most recent regular partner. The 9-point scale of relationship intimacy was
found to be reliable for both SW (Alpha=.80) and clients (Alpha=.78). In multivariate logistic regression controlling for demographic factors such as age, education
and SES, higher intimacy (strongly agreeing w/ &iexcl;Y5 items) was significantly
associated with an increased odds of non-CCU of among both SW (OR 5.07;
p=.0000) and regular paying partners (OR 1.88; p=.015). However, the predictive
power of intimacy was significantly stronger among women than among men.
Conclusions: Relationship intimacy is significantly associated with non-CCU for
both SW and regular paying partners. The influence of intimacy is stronger among
women due to gender norms that emphasize the need for intimacy. The social
construction of intimacy plays an important role in shaping womens risk for HIV
and should be addressed in future prevention programs.

Presenting author: Deanna Kerrigan, 615 N Wolfe St E7141, Baltimore MD
21205, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]

WePeE6559 Challenges to social integration and solidarity
among female sex workers and vulnerability to HIV
and other STIs in Rio de Janeiro, Brazil
H. Torres', P. Telles', P. Longo', C. Castle2, C. Overs3, D. Kerrigan4. 1SEPED,
Horizons/Population Council, 4301 Connecticut Ave NW Suite 280, Washington
DC 20008, Brazil; 2Horizons/lInternational HIV/AIDS Alliance, Washington,
United States; 3/nternational HIV/AIDS Alliance, Brighton, United Kingdom;
4Horizons/Johns Hopkins University, Baltimore, United States
Background: The Sonagachi Project in India is particularly known for building
a community among sex workers (SWs) and supporting demands for sex work
to be recognized as a legitimate occupation as the foundation of its successful
sexual health strategy. Yet little research exists on the effect this has on reducing
SWs' vulnerability to HIV. Indicators for assessing the impact of community development among SWs was developed by the Sonagachi project and later adapted
for use in 3 sites in Rio de Janeiro. This abstract highlights key barriers to establishing social integration and solidarity among Brazilian SWs in our study.
Methodology: Pre-intervention survey data were collected from mostly streetbased female SWs (n=499), as well as from in-depth interviews (n=37) with SWs
and others involved in commercial sex.
Results: Respondents perceive that fewer clients and increasing numbers of
SWs have contributed to greater competition and rivalry among sex workers, with
61% of the sample agreeing that colleagues only had concern for themselves.
Several sources of violence were identified by respondents and violence between
SWs was perceived as a key barrier to building a sense of community and fostering collective action to address crucial issues such as violence itself. Only 27% of
women experiencing violence said they sought police assistance because their
slow response adds to the women's sense of vulnerability and isolation. Women
who did not report experiencing violence in the last 4 months also reported a
higher rate of consistent condom use with all partners in the last 4 months (OR
1.75; Cl 1.00-3.05; p=.047) than those who did experience violence (67.1%).
Conclusions: Activities to overcome barriers to social integration and solidarity
are underway in Brazil in response to baseline data, including a drop-in center
with social activities, small visual storybooks to raise awareness about violence
and how to respond to it, and the distribution of anti-violence kits.
Presenting author: Christopher Castle, Horizons/Population Council, 4301 Connecticut Ave NW, Suite 280, Washington DC 20008, United States, Tel.: +1 202
237 9412, Fax: [phone], E-mail: [email protected]
WePeE6560 Participatory mapping of sex trade and
enumeration of sex workers (SWs) using
capture-recapture methodology (CRM) in
Diego-Suarez, Madagascar
N. Kruse, F. Behets2, G. Burkhardt', T. Barivelo3, A. Amida3, G. Dallabetta1,
D. Rasamilalao4, G. Vaovola5. 'Family Health International, Family Health
International, 2101 Wilson Blvd., Suite 700, Arlington, VA 22201, United States;
2Department of Medicine, Dept. of Epidemiology School of Public Health,
University of North Carolina, Chapel Hill, NC, United States; 3Ministry of
Health/Madagascar, Diego-Suarez, Madagascar; 4Ministry of
Health/Madagascar, Antananarivo, Madagascar; 5FIVMATA, Diego-Suarez,
Madagascar
Background: Capture-recapture methodology (CRM) has been used to estimate
the size of hidden or difficult-to-reach populations. To plan interventions for sex
workers (SWs) in Diego-Suarez, information was needed about the local sex trade
and the number of SWs.
Methods: SW peer educators were trained in mapping techniques and CRM and
served as field agents. Geographic maps were developed per neighborhood noting sex trade sites (STS) and times of activity. STS were grouped into 19 clusters
by proximity, time of activity and expected number of SWs. A two-sample CRM
was used. SWs were "tagged" using an educational brochure. The total population was estimated using the following formula:
[(number of 2nd round new captures + number of recaptures) * (number of 1st
round captures)]/recaptures
Results: STS were defined (i.e., neighborhoods, bars, streets, corners, markets,
pass houses, discos, "taxi-brousse" stations, port) where SWs engaged clients;
most SWs were street-based and mobile, moving from site to site depending on
time of day, day of week, and season.
Round One Round Two
New captures 1455 599
"Mobility" or captured more than once in same round 286 (19.7%)
Recaptures - 292 + 417" = 709
"Trap avoidance" or Refusals 58* (4%) 136" (10.4%)
"possibly identified more than once. Total population was estimated at 2,684 SWs.
Conclusions: Geographic mapping and enumeration were useful in obtaining information about local sex work. SWs were enthusiastic and effective field agents

given adequate support.
Presenting author: Natalie Kruse, Family Health International, 2101 Wilson
Blvd., Suite 700, Arlington, VA 22201, United States, Tel.: [phone], Fax:
[phone], E-mail: [email protected]