Background Since 2004, FHI has been implementing Aastha, a Bill & Melinda Gates Foundation supported HIV/STI prevention project for 24 000 sex workers (SWs) in Mumbai and Thane. It provides STI services to approximately 11 000 SWs monthly. HIV counselling and testing services were strengthened from March 2009 and by October 2010, 13 669 individuals had been tested for HIV. This abstract discusses the prevalence of HIV in female sex workers (FSWs) registered with the project by age and typology. When the project commenced its intervention in 2004, the HIV prevalence in brothel-based FSWs according to the HIV Sentinel Survey 2004 was 44.76%.
Methods From March 2009 to October 2010, 13 669 FSWs underwent voluntary counselling and testing for HIV. The results were analysed across age and typology. HIV tests were conducted and interpreted as per Indian national guidelines using three rapid tests.
Results Of the 13 669 tested, 623 individuals tested HIV-positive for HIV (4.6%). Among the 623 HIV-positive individuals, 177 individuals (28.4%) were aged 18–24 years; 404 individuals (64.8%) were aged 25–36 years and 42 individuals (6.7%) were aged 37 years or older. By FSW typology, HIV prevalence was as follows—13.1% brothel-based; 3.3% bar-based; 4.7% street-based; 1.6% home-based; and 1.6% lodge-based. The difference in HIV prevalence is statistically highly significant across different typologies (p=0.0001). All the sex workers who tested HIV-positive and were willing to disclose their status were linked to care, support and treatment services.
Conclusions In this study, overall HIV prevalence among sex workers was 4.6%. The highest HIV prevalence (13.1%) was observed in the brothel-based SWs. A change in the national policy for HIV testing for brothel-based sex workers from biannually to quarterly is recommended. Historically, in Maharashtra, it has been observed that brothel-based sex workers have high incidence and this has been corroborated even after scaling up testing in this group. Given this scenario and considering the duration of the window period in any high-risk group, we can inform policy-makers to increase the frequency of HIV testing. This will provide an opportunity for early testing and inclusion of newly identified HIV-positives for referral for care and treatment.