Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. This article has been cited by other articles in PMC. Abstract Background It is important for targeted interventions to consider vulnerabilities of female sex workers FSWs such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus HIV prevention.
Materials and methods Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in with 2, FSWs recruited in Mumbai and Thane. Dependent measures included service uptake, self-confidence, self-identity, and individual agency.
Logistic regression analysis was used to examine the study objectives. Results Of the analytical sample of 2, FSWs, 1, Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months adjusted odds ratio [AOR] 2.
HIV, vulnerability, FSWs, India, prevention Background Various studies have shown a shift in focus from condom programming and provision of clinical services to initiatives that address the contextual factors underlying human immunodeficiency virus HIV risk and vulnerability 1 among high-risk groups. The Aastha project, funded by the Bill and Melinda Gates Foundation, a scaled-up HIV-prevention intervention since to date across Mumbai and Thane with a heterogeneous population of sex workers in an urban setting, is a case in point.
Power dynamics play a crucial role in the sex industry and in the lives of FSWs, right from the scope of negotiation with clients and partners on condom use and sexual acts and managing the control and influence of stakeholders, such as brothel owners, bar owners, brothel managers, and local thugs. However, what makes some FSWs more vulnerable than others? This paper postulates that it is the continuous interaction of various socioeconomic factors and aspects of sex work itself that together contribute toward making FSWs vulnerable, and some FSWs more than others.
Recently, through various syndemics, it has become increasingly clear that diseases do not occur in isolation, and social conditions of those who are suffering from these diseases are important factors to consider in order to understand the health impact on these individuals. A set of social and economic factors appear to be associated with ideas, attitudes, and behaviors. It thus has three coordinates: This paper contributes to the existing body of knowledge in this aspect by defining vulnerability and considering specific aspects.
Recent studies have explored the role of various factors separately, such as poverty, illiteracy, duration in sex work, and mobility for work among FSWs, contributing toward HIV vulnerability. In a study in the four high-prevalence Indian states, including Maharashtra, a higher degree of mobility was associated with higher rates of inconsistent condom use with clients and regular partners. Poor economic conditions were the primary reason for entry into sex work.
Figure 1 illustrates the interaction and interface of various factors of vulnerability, which lead to differing degrees and types of vulnerability. There is a need to bring together individual factors to construct an index that considers all the important vulnerability factors. Therefore, this paper attempts: