An integrated structural intervention to reduce vulnerability to HIV and sexually transmitted infections among female sex workers in Karnataka state, south India.
An integrated structural intervention to reduce vulnerability to HIV and sexually transmitted infections among female sex workers in Karnataka state, south India.
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DOI：
10.1186/1471-2458-11-755
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发表时间：
2011-10-02
影响因子：
4.5
通讯作者：
Blanchard JF
中科院分区：
文献类型：
--
作者：
Gurnani V;Beattie TS;Bhattacharjee P;CFAR Team;Mohan HL;Maddur S;Washington R;Isac S;Ramesh BM;Moses S;Blanchard JF
众所周知，结构性因素会影响个人感染艾滋病毒的风险和脆弱性。在针对印度南部 60,000 多名女性性工作者 (FSW) 的艾滋病毒预防计划的背景下，我们制定了涉及政策制定者、次要利益相关者（警察、政府官员、律师、媒体）和主要利益相关者（FSW 本身）的结构性干预措施。干预措施的目的是解决导致艾滋病毒脆弱性的具体因素（社会不平等、暴力和骚扰、耻辱和歧视）。我们向政府当局倡导将艾滋病毒/艾滋病作为一个经济、社会和发展问题，并请求政治领导将艾滋病毒/艾滋病问题纳入整个政府计划。我们动员了外籍劳工并评估了他们的合法权利，并与外籍劳工和艾滋病毒/艾滋病感染者合作，为超过 175 名政府官员、13,500 名警察和 950 名记者开展了宣传和认识培训。 2007 年至 2009 年间，每月从卡纳塔克邦 18 个地区收集有关服务提供、服务利用和社区活动的标准化常规项目监测指标。2005 年至 2008 年间，在选定的地区对有关艾滋病毒/艾滋病和女性社会工作者的新闻文章进行了每日手动跟踪。艾滋病毒预防计划目前正在大规模运作，同伴教育者定期与超过 60,000 名女性工作者联系，还有超过 17,000 名女性工作者定期与他们联系。 FSW 每月获得性传播感染项目服务。社区组织中的 FSW 成员已从 8,000 名增加到 37,000 名，目前已有超过 46,000 名 FSW 被转介以获得政府资助的社会福利。 2007 年至 2009 年间，所报告的 4,600 起暴力和骚扰事件中，超过 90% 的暴力和骚扰事件都得到了支持，FSW 得到了纠正，对新闻报道的监测显示，关于艾滋病毒/艾滋病和 FSW 的正面媒体报道数量增加了 50%。污名、歧视、暴力、骚扰和社会公平问题是外劳的主要关注点。本报告表明，作为大规模艾滋病毒预防规划的一部分，解决这些更广泛的结构性因素是可能的。尽管评估结构性干预措施的各个组成部分对减少艾滋病毒脆弱性的影响很困难，但解决导致女性性伴侣脆弱性的更广泛的结构性因素至关重要，以使这些脆弱妇女能够充分赋权，采取有效应对艾滋病毒流行所需的更安全的性行为。
Structural factors are known to affect individual risk and vulnerability to HIV. In the context of an HIV prevention programme for over 60,000 female sex workers (FSWs) in south India, we developed structural interventions involving policy makers, secondary stakeholders (police, government officials, lawyers, media) and primary stakeholders (FSWs themselves). The purpose of the interventions was to address context-specific factors (social inequity, violence and harassment, and stigma and discrimination) contributing to HIV vulnerability. We advocated with government authorities for HIV/AIDS as an economic, social and developmental issue, and solicited political leadership to embed HIV/AIDS issues throughout governmental programmes. We mobilised FSWs and appraised them of their legal rights, and worked with FSWs and people with HIV/AIDS to implement sensitization and awareness training for more than 175 government officials, 13,500 police and 950 journalists. Standardised, routine programme monitoring indicators on service provision, service uptake, and community activities were collected monthly from 18 districts in Karnataka between 2007 and 2009. Daily tracking of news articles concerning HIV/AIDS and FSWs was undertaken manually in selected districts between 2005 and 2008. The HIV prevention programme is now operating at scale, with over 60,000 FSWs regularly contacted by peer educators, and over 17,000 FSWs accessing project services for sexually transmitted infections monthly. FSW membership in community-based organisations has increased from 8,000 to 37,000, and over 46,000 FSWs have now been referred for government-sponsored social entitlements. FSWs were supported to redress > 90% of the 4,600 reported incidents of violence and harassment reported between 2007-2009, and monitoring of news stories has shown a 50% increase in the number of positive media reports on HIV/AIDS and FSWs. Stigma, discrimination, violence, harassment and social equity issues are critical concerns of FSWs. This report demonstrates that it is possible to address these broader structural factors as part of large-scale HIV prevention programming. Although assessing the impact of the various components of a structural intervention on reducing HIV vulnerability is difficult, addressing the broader structural factors contributing to FSW vulnerability is critical to enable these vulnerable women to become sufficiently empowered to adopt the safer sexual behaviours which are required to respond effectively to the HIV epidemic.
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影响因子：
4.5
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
通讯作者：
Moses S
DOI：
10.1080/09540120500466937
发表时间：
2006-10-01
影响因子：
1.7
作者：
Halli, S. S.;Ramesh, B. M.;Blanchard, J. F.
通讯作者：
Blanchard, J. F.
影响因子：
168.9
作者：
Ellsberg, Mary;Jansen, Henrica A. F. M.;Garcia-Moreno, Claudia
通讯作者：
Garcia-Moreno, Claudia
影响因子：
3.6
作者：
Bradley J;Moses S;Blanchard JF;Rajaram S;Ramesh BM;Verma S;Alary M
通讯作者：
Alary M
影响因子：
3.1
作者：
Choi, Susanne Y. P.;Chen, K. L.;Jiang, Z. Q.
通讯作者：
Jiang, Z. Q.