Document 0305
 DOCN  M9650305
 TI    Impact of an intervention on HIV, sexually transmitted diseases, and
       condom use among sex workers in Bombay, India.
 DT    9605
 AU    Bhave G; Lindan CP; Hudes ES; Desai S; Wagle U; Tripathi SP; Mandel JS;
       AIDS Surveillance Center, Department of Microbiology, Seth G.S.; Medical
       College, Bombay, India.
 SO    AIDS. 1995 Jul;9 Suppl 1:S21-30. Unique Identifier : AIDSLINE
       MED/96085740
 AB    OBJECTIVE: To develop and test an HIV intervention targeting sex workers
       and madams in the brothels of Bombay. SUBJECTS AND METHODS: In a
       controlled intervention trial, with measurements before and after the
       intervention, 334 sex workers and 20 madams were recruited from an
       intervention site, and 207 and 17, respectively, from a similar control
       site, both in red-light areas of Bombay. All sex workers were tested for
       antibodies to HIV and syphilis, and for hepatitis B surface antigen.
       Information on sexual practices, condom use and knowledge of HIV was
       collected by interviewer-administered questionnaire. All subjects in the
       intervention group underwent a 6-month program of educational videos,
       small group discussions and pictorial educational materials; free
       condoms were also distributed. The blood tests and the questionnaire
       were readministered to all subjects at both sites immediately after the
       intervention. Both groups were followed for approximately 1 year.
       RESULTS: The baseline level of knowledge about HIV and experience with
       condoms was extremely low among both sex workers and madams. The
       baseline prevalence of HIV antibodies was 47% in the intervention group
       and 41% in the control group (P = 0.17). The incidence densities for HIV
       and sexually transmitted diseases were significantly different in the
       two groups (all P < 0.005): 0.05 and 0.16 per person-year of follow-up
       for HIV, 0.08 and 0.22 per person-year for antibodies to syphilis, and
       0.04 and 0.12 per person-year for hepatitis B surface antigen in the
       intervention and control women, respectively. Following the
       intervention, women reported increased levels of condom use, and some
       (41%) said they were willing to refuse clients who wouldn't use them.
       However, both the sex workers and the madams were concerned about losing
       business if condom use was insisted upon. CONCLUSIONS: Both HIV
       prevalence and incidence are alarmingly high among female sex workers in
       Bombay. Successful interventions can be developed for these women, and
       even a partial increase in condom use may decrease the transmission of
       HIV and sexually transmitted diseases. Intervention programs of longer
       duration that target madams and clients and make condoms easily
       available are urgently needed at multiple sites in red-light areas.
 DE    Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/*PREVENTION &
       CONTROL/TRANSMISSION  Adolescence  Adult  Audiovisual Aids
       Condoms/*STATISTICS & NUMER DATA  Cross-Sectional Studies  *Developing
       Countries  Female  Follow-Up Studies  *Health Education  Hepatitis
       B/EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION  Human  Incidence
       India/EPIDEMIOLOGY  Knowledge, Attitudes, Practice  Middle Age
       Prostitution/*STATISTICS & NUMER DATA  Risk Factors  Sexually
       Transmitted Diseases/EPIDEMIOLOGY/*PREVENTION & CONTROL/  TRANSMISSION
       Support, Non-U.S. Gov't  Support, U.S. Gov't, P.H.S.
       Syphilis/EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION  Urban
       Population/*STATISTICS & NUMER DATA  CLINICAL TRIAL  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).