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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 Jayanna1,3,
  2. Reynold G Washington1,2,3,
  3. Stephen Moses2,
  4. Prakash Kudur1,
  5. Shajy Issac1,
  6. P S Balu1,
  7. Sanjeev Badiger1,
  8. Vivian Mendonca1,
  9. Santosh Bhavimani1,
  10. Pradeep Banandur1,3
  1. 1Karnataka Health Promotion Trust, Bangalore India
  2. 2University of Manitoba, Winnipeg, Canada
  3. 3St John's Medical College, Bangalore, India
  1. Correspondence to Krishnamurthy Jayanna, Karnataka Health Promotion Trust, IT/BT Park, #1–4, Industrial Area, Behind KSSIDC Administrative Office, Rajajinagar, Bangalore 560044, India; dr_krishnamurthy{at}, krishnamurthy{at}


Background A key component of prevention programmes aimed at reducing the risk of HIV and sexually transmitted infections (STI) among high-risk groups such as female sex workers (FSW) 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 FSW, and the perceptions of FSW towards STI services, following training.

Methodology After an intensive physician capacity building programme, 393 exit interviews of FSW 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 FSW to understand the 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 improve further the attitudes of providers towards sex work, and improve practices such as speculum examination and partner referral that can enhance quality of care.

  • Attitudes
  • care providers
  • community
  • community involvement
  • patients' views
  • qualitative research
  • quality
  • sex work
  • STD services
  • targeted interventions

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  • Funding This work was carried out under the India AIDS initiative (Avahan), of the Bill & Melinda Gates Foundation. The contents of this paper do not necessarily reflect the views of the foundation. The views expressed are those of the authors and cannot be taken to reflect the official opinion of the institutions to which the authors are affiliated.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Institutional Ethical Review Board, St John's Academy of Health Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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