Assessing reported condom use among female sex workers in southern India through examination of condom availability
- Janet Bradley1,
- Stephen Moses2,3,
- James F Blanchard2,3,
- S Rajaram1,
- B M Ramesh2,
- Supriya Verma1,
- Michel Alary
- 1CHARME-India Project, Bangalore, India
- 2University of Manitoba, Winnipeg, Canada
- 3Karnataka Health Promotion Trust, Bangalore, India
- 4Centre Hospitalier Affilié Universitaire de Québec, Québec, Canada
- Correspondence to J Bradley, KHPT office, IT/BT Park 4th and 5th Floor, #1-4, Rajajinagar Industrial Area, Behind KSSIDC Administrative Office, Rajajinagar, Bangalore, India 560 044;
Contributors JB conceived the idea for the paper, managed the analysis and wrote the manuscript. SM, JFB, MA and BMR assisted with study design and assisted with revisions of the paper. SV and SR assisted with data collection and analysis and reviewed the manuscript.
- Accepted 18 November 2009
Objectives A key indicator of success of HIV prevention programmes is the number of female sex worker (FSW) sex acts protected by condoms. This measure usually relies on FSW reports, which may be biased. We examined condom availability data in five Karnataka districts to estimate the proportion of FSW sex acts potentially protected by condoms.
Methods Financial, programme, population, condom and contraceptive data were obtained from governmental and non-governmental sources, surveys and HIV prevention programmes. Sexual behaviour data were obtained from general population and FSW surveys. We examined four scenarios in a sensitivity analysis, each one assuming different proportions of available condoms that might have been used by sex workers.
Results Possible condom use rates for all FSW sex acts ranged from 3%–36% in 2004 to 56%–96% in 2008. The two most realistic scenarios that discounted the number of private sector condoms that might have been bought for sex acts other than with FSWs showed that 16–24% of FSW sex acts could have been protected by condoms in 2004 rising to 77–85% in 2008.
Conclusions These data suggest that condom availability in these Karnataka districts in 2004 was low in relation to the number of FSW sex acts, but rose substantially over the ensuing 4 years. Condom availability data can be useful for triangulation with other available data, such as self-reported condom use, to provide a range of possibilities regarding the number of FSW sex acts protected by condoms.
Funding This research was funded by the Bill & Melinda Gates Foundation. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Bill & Melinda Gates Foundation.
Competing interests None.
Ethics approval This study was approved by the ethics committees of the University of Manitoba, Centre Hospitalier Affilié Universitaire de Québec and St John's Medical College.
Provenance and peer review Not commissioned; externally peer reviewed.