Violence against female sex workers in Karnataka state, south India: impact on health, and reductions in violence following an intervention program.
Violence against female sex workers in Karnataka state, south India: impact on health, and reductions in violence following an intervention program.
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DOI：
10.1186/1471-2458-10-476
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发表时间：
2010-08-11
影响因子：
4.5
通讯作者：
Moses S
中科院分区：
文献类型：
--
作者：
Beattie TS;Bhattacharjee P;Ramesh BM;Gurnani V;Anthony J;Isac S;Mohan HL;Ramakrishnan A;Wheeler T;Bradley J;Blanchard JF;Moses S
针对女性性工作者的暴力行为会阻碍艾滋病毒预防工作，侵犯她们的人权。我们开发了针对政策制定者、二级利益相关者(警察、律师、媒体)和主要利益相关者(FSWs)的多层次暴力干预，作为涉及卡纳塔克邦60000名FSWs的更广泛艾滋病毒预防方案的一部分。这项研究调查了针对暗娼的暴力是否与避孕套使用的减少和STI/HIV风险的增加有关，以及在大规模艾滋病毒预防计划中解决针对暗娼的暴力是否可以减少针对她们的暴力水平。妇女工作人员被随机挑选参加投票站调查(公共广播服务2006-2008年；匿名发放的简短行为问卷)和综合行为-生物评估(2005-2009年接受国际公共广播协会调查；面对面接受调查)。3852名FSWs参加了IBBA，7638名FSWs参加了PBS。总体而言，在过去的一年里，11.0%的IBBA和26.4%的PBS的FSWs报告被殴打或强奸。在过去的一年中，报告暴力行为的暗娼报告与客户发生无保护措施的性行为的可能性显著降低(前一个月无保护措施的性行为，55.4%比75.5%，调整后的优势比0.4，95%的可信区间0.3至0.5p<；0.001)；有过艾滋病干预计划的人(有过同伴教育者联系过的，84.9%比89.6%，aOR0.7，95%CI0.4至1.0，p=0.04)；或曾到项目性健康诊所就诊(59.0%vs.68.1%，AOR 0.7，95%CI 0.6~1.0，p=0.02)；感染淋病的可能性显著增加(5.0%vs.2.6%，AOR 1.9，95%CI 1.1~3.3，p=0.02)。通过跟踪调查，与基线相比，暗娼报告暴力的比例显著下降(IBBA 13.0%比9.0%，AOR 0.7，95%CI 0.5至0.9P=0.01；PBS 27.3%比18.9%，粗略OR 0.5，95%CI 0.4至0.5，p<；0.001)。这一方案表明，解决暴力问题的结构性办法可以有效地大规模实施。解决针对暗娼的暴力行为对于艾滋病预防项目的成功和保护她们的基本人权是重要的。
Violence against female sex workers (FSWs) can impede HIV prevention efforts and contravenes their human rights. We developed a multi-layered violence intervention targeting policy makers, secondary stakeholders (police, lawyers, media), and primary stakeholders (FSWs), as part of wider HIV prevention programming involving >60,000 FSWs in Karnataka state. This study examined if violence against FSWs is associated with reduced condom use and increased STI/HIV risk, and if addressing violence against FSWs within a large-scale HIV prevention program can reduce levels of violence against them. FSWs were randomly selected to participate in polling booth surveys (PBS 2006-2008; short behavioural questionnaires administered anonymously) and integrated behavioural-biological assessments (IBBAs 2005-2009; administered face-to-face). 3,852 FSWs participated in the IBBAs and 7,638 FSWs participated in the PBS. Overall, 11.0% of FSWs in the IBBAs and 26.4% of FSWs in the PBS reported being beaten or raped in the past year. FSWs who reported violence in the past year were significantly less likely to report condom use with clients (zero unprotected sex acts in previous month, 55.4% vs. 75.5%, adjusted odds ratio (AOR) 0.4, 95% confidence interval (CI) 0.3 to 0.5, p < 0.001); to have accessed the HIV intervention program (ever contacted by peer educator, 84.9% vs. 89.6%, AOR 0.7, 95% CI 0.4 to 1.0, p = 0.04); or to have ever visited the project sexual health clinic (59.0% vs. 68.1%, AOR 0.7, 95% CI 0.6 to 1.0, p = 0.02); and were significantly more likely to be infected with gonorrhea (5.0% vs. 2.6%, AOR 1.9, 95% CI 1.1 to 3.3, p = 0.02). By the follow-up surveys, significant reductions were seen in the proportions of FSWs reporting violence compared with baseline (IBBA 13.0% vs. 9.0%, AOR 0.7, 95% CI 0.5 to 0.9 p = 0.01; PBS 27.3% vs. 18.9%, crude OR 0.5, 95% CI 0.4 to 0.5, p < 0.001). This program demonstrates that a structural approach to addressing violence can be effectively delivered at scale. Addressing violence against FSWs is important for the success of HIV prevention programs, and for protecting their basic human rights.
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影响因子：
7.7
作者：
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通讯作者：
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影响因子：
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DOI：
10.1080/09540120500466937
发表时间：
2006-10-01
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影响因子：
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