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Assessment of attitudes and practices of providers of services for individuals at high risk of HIV and sexually transmitted infections in Karnataka, South India
  1. Krishnamurthy Jayanna1,*,
  2. Reynold Washington1,
  3. Stephen Moses2,
  4. Prakash Kudur1,
  5. Shajy Issac1,
  6. Balu PS1,
  7. Santosh Bhavimani1,
  8. Vivian Mendonca1,
  9. Sanjeev Badiger1,
  10. Pradeep Banandur1
  1. 1 Karnataka Health Promotion Trust, India;
  2. 2 University of Manitoba, Canada
  1. Correspondence to: KRISHNAMURTHY JAYANNA, HIV and Infectious diseases, St Johns Research Institute, St Johns Academy of Health Sciences, India, Karnataka Health Promotion Trust, IT/BT Park, #1-4, Industrial Area, Behind KSSIDC Adminstrative Office, Rajajinagar, Bangalore, 560044, India; krishnamurthy{at}


Background: A key component of prevention programmes aimed at reducing risk for HIV and sexually transmitted infections (STIs) among high risk groups such as female sex workers (FSWs) is the provision of quality STI services. The attitudes and practices of care providers are critical factors in the provision of services, and in achieving better participation of high risk individuals in accessing services.

Objectives: To assess the attitudes and practices of STI care providers towards female sex workers, and the perceptions of FSWs towards STI services, following training.

Methodology: After an intensive physician capacity building programme, 393 exit interviews of FSWs were conducted following clinical encounters, and discussions were held with 131 STI care providers (physicians) across several districts in Karnataka. Focus group discussions were held among FSWs to understand perceptions of non-users of services.

Results: 60% of women reported that the clinics were accessible. 76% of the women who visited clinics for STI consultations were offered a speculum examination. 85% received a condom demonstration, but only 52% were advised for partner treatment. 69% of women were referred for HIV testing. 79% of physicians felt that sex workers were responsible for spreading HIV in the community, and 47% believed that sex work should be banned to control HIV.

Conclusions: Following physician training, quality of care appears to be generally acceptable, but it is important to further improve the attitudes of providers towards sex work, and improve practices such as speculum examination and partner referral that can enhance quality of care.

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