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Change over Time in Police Interactions and HIV Risk Behavior Among Female Sex Workers in Andhra Pradesh, India

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Abstract

Little is known about the effectiveness of intervening to change interactions between female sex workers (FSWs) and police in order to reduce HIV risk. Using data collected in the context of a HIV prevention intervention that included components to change policing practices (n = 1,680), we examine the association of FSWs’ reports of negative police interactions and HIV risk behaviors and whether these associations varied over time. Results show negative police interactions declined significantly over time. FSWs who had more than one negative police interaction were more likely to experience STI symptoms (AOR 2.97 [95 % CI 2.27–3.89]), inconsistently use condoms with their clients (AOR 1.36 [95 % CI 1.03–1.79]), and accept more money for condomless sex (AOR 2.37 [95 % CI 1.76–3.21]). Over time, these associations were stable or increased. Even where interventions have reduced the number of police incidents experienced by FSWs, stakeholders in HIV prevention must remain vigilant in challenging these incidents.

Resumen

Se sabe poco sobre la eficacia de las intervenciones que intentan de cambiar las interacciones entre las trabajadoras sexuales y oficiales de la policía, con el fin de reducir el riesgo de VIH. Utilizando datos recogidos como parte de una intervención de prevención del VIH que incluía componentes para cambiar las prácticas policiacas (n = 1680), se analiza la asociación de los reportes de trabajadores sexuales de interacciones negativas con oficiales de la policía y los comportamientos de alto riesgo de VIH; además, si estas asociaciones varían tras tiempo. Los resultados muestran que las interacciones negativas con oficiales de la policía disminuyeron significativamente tras tiempo. Respondientes que tenían más de una interacción negativa con la policía eran más propensos a experimentar síntomas de ITS (AOR 2,97 [95 % CI: 2,27 a 3,89]), a no usar condones con sus clientes (AOR 1,36 [95 % CI: 1,03 a 1,79]), e a aceptar más dinero para el sexo sin condón (AOR 2,37 [95 % CI: 1,76 a 3,21]). Tras el tiempo, estas asociaciones se mantuvieron estables o aumentaron. Aun cuando las intervenciones se han reducido el número de incidentes policiacas experimentados por las trabajadores sexuales, toda gente interesada en la prevención del VIH debe permanecer vigilante en desafiar estos incidentes.

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Acknowledgments

This work was supported by the Bill & Melinda Gates Foundation through Avahan, the India AIDS Initiative. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position or the Bill & Melinda Gates Foundation and Avahan. The authors wish to thank all the women who participated in the cross-sectional survey, the Rajahmundry NGO CARE-Saksham, and Project Parivartan team members in India and the USA.

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Authors and Affiliations

  1. Department of Public Health Education, University of North Carolina, P.O. Box 26170, Greensboro, NC, 27402-6170, USA

    Jennifer Toller Erausquin

  2. Division of Global Public Health, School of Medicine, University of California, San Diego, CA, USA

    Elizabeth Reed

  3. Department of Sociology, American University, Washington, DC, USA

    Kim M. Blankenship

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  1. Jennifer Toller Erausquin
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  2. Elizabeth Reed
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Correspondence to Jennifer Toller Erausquin.

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Erausquin, J.T., Reed, E. & Blankenship, K.M. Change over Time in Police Interactions and HIV Risk Behavior Among Female Sex Workers in Andhra Pradesh, India. AIDS Behav 19, 1108–1115 (2015). https://doi.org/10.1007/s10461-014-0926-5

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