| Titre : | Assessing the role of community mobilisation in a scaled HIV prevention programme among marginalized populations in India - findings from Avahan. Risk reduction and perceived collective efficacy and community support among female sex workers in Tamil Nadu and Maharashtra, India : the importance of context. (2012) |
| Auteurs : | Mohua GUHA ; Angela BASCHIERI ; Shalini BHARAT ; BHATNAGAR (Tarun) : IND. National Institute of Epidemiology (Icmr). Chennai. ; Martine COLLUMBIEN ; Isabelle DE ZOYSA, éd. ; Sheela-V GODBOLE ; . MANDAR KESHAV MAINKAR ; P.S. SARAVANAMURTHY ; . SUVARNA SANJAY SANE ; Joseph Williams ; Centre for Health & Social Sciences. School of Health Systems Studies. Tata Institute of Social Sciences. Mumbai. IND ; Chartered Voluntary Health Services. Chennai. IND ; Department for Population Studies. London School of Hygiene and Tropical Medicine. London. GBR ; National Aids Research Institute Icmr Pune. IND |
| Type de document : | Article |
| Dans : | Journal of epidemiology and community health (vol. 66, 2012) |
| Pagination : | ii55-ii61 |
| Langues: | Anglais |
| Mots-clés : | Facteur risque ; Risque ; Participation communautaire ; Femme ; Prostitution ; Homme ; Inde ; Asie |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xHDDr8. Diffusion soumise à autorisation]. Background Empowering sex workers to mobilise and influence the structural context that obstructs risk reduction efforts is now seen an essential component of successful HIV prevention programmes. However, success depends on local programme environments and history. Methods The authors analysed data from the Integrated Behavioural and Biological Assessment Round I cross-sectional survey among female sex workers in Tamil Nadu and Maharashtra. The authors used propensity score matching to estimate the impact of participation in intervention activities on reduction of risk (consistent condom use) and vulnerability (perceived collective efficacy and community support). Results Background levels of risk and vulnerability as well as intervention impact varied widely across the different settings. The effect size ATT of attending meetings/trainings on consistent condom use was as high as 21% in Tamil Nadu (outside of Chennai) where overall use was lowest at 51%. Overall, levels of perceived collective efficacy were low at the time of the survey ; perceived community support was high in Tamil Nadu and especially in Chennai (93%) contrasting with 33% in Mumbai. Consistent with previous research, the context of Mumbai seems least conducive to vulnerability reduction, yet self-help groups had a significant impact on consistent condom use (ATT=10%) and were significantly associated with higher collective efficacy (ATT=31%). Conclusions Significant risk reduction can be achieved by large-scale female sex worker interventions, but the impact depends on the history of programming, the complexity of the context in which sex work happens and pre-existing levels of support sex workers perceive from their peers. |
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