Kumar G Anil, Dandona Rakhi, Gutierrez Juan Pablo, McPherson Sam, Bertozzi Stefano M, Dandona Lalit
Centre for Human Development, Administrative Staff College of India, Raj Bhavan Road, Hyderabad 500082, Andhra Pradesh, India.
Natl Med J India. 2006 Nov-Dec;19(6):306-12.
Condoms are an essential part of comprehensive HIV prevention and care programmes. We report the accessibility of male condoms for female sex workers (FSWs) and the associated characteristics that may play a major role in determining access to condoms for FSWs.
Confidential interviews of 6509 street- and home-based FSWs in 13 districts of the Indian state of Andhra Pradesh provided data on the number of paying clients and various aspects of access to free condoms and purchase of condoms. Access to condoms was defined as having ever obtained condoms either through free distribution or through purchase. Multivariate analyses were done separately for street- and home-based FSWs to describe correlates of their access to condoms. The requirement of condoms was assessed based on the number of paying clients during the past 15 days.
Data on condom access were available for 6465 (99.3%) FSWs. A total of 2850 (44.1%; 95% CI: 36.2%-52.0%) reported accessing free condoms ever and 2336 (36.1%; 95% CI: 30.6%-41.6%) had purchased condoms ever (not mutually exclusive). The primary sources for condoms were non-governmental organization facilities (73.8%) and pharmacies (79.7%) for free and purchased condoms, respectively. A total of 3510 (54.3%; 95% CI: 48.5%-60.1%) FSWs reported no access to free or purchased condoms during the past 15 days, and this no access was significantly higher for those > 30 years of age, with no schooling, street-based FSWs, and with no participation in a FSW support group (p < 0.001 for each in univariate analysis). Participation in a FSW support group was the main predictor of access to free condoms for both types of FSWs during the past 15 days with multivariate analysis. Condom requirements during the past 15 days were met for 67.5% of FSWs who had accessed only free condoms and for 33.8% of those who had accessed only purchased condoms.
One-fourth of FSWs had never accessed condoms, and a little over half of those who had ever accessed reported no access during the past 15 days. Condom requirements were not met for three-fifths of the FSWs. HIV prevention programmes need to Increase access to free condoms for FSWs in Andhra Pradesh as access to condoms is a necessary prerequisite for condom use.
避孕套是全面艾滋病毒预防和护理计划的重要组成部分。我们报告了女性性工作者获取男用避孕套的情况以及可能在决定女性性工作者获取避孕套方面发挥主要作用的相关特征。
对印度安得拉邦13个地区的6509名街头和上门服务的女性性工作者进行保密访谈，获取了付费客户数量以及免费避孕套获取和购买避孕套的各个方面的数据。获取避孕套的定义为曾通过免费发放或购买获得过避孕套。分别对街头和上门服务的女性性工作者进行多变量分析，以描述她们获取避孕套的相关因素。根据过去15天内的付费客户数量评估避孕套需求。
6465名（99.3%）女性性工作者提供了避孕套获取数据。共有2850名（44.1%；95%置信区间：36.2%-52.0%）报告曾获取过免费避孕套，2336名（36.1%；95%置信区间：30.6%-41.6%）曾购买过避孕套（并非相互排斥）。免费和购买避孕套的主要来源分别是非政府组织设施（73.8%）和药店（79.7%）。共有3510名（54.3%；95%置信区间：48.5%-60.1%）女性性工作者报告在过去15天内未获取免费或购买的避孕套，对于年龄大于30岁、未受过教育、街头工作的女性性工作者以及未参加女性性工作者支持小组的人来说，这种未获取情况显著更高（单变量分析中每项p<0.001）。多变量分析显示，参加女性性工作者支持小组是两类女性性工作者在过去15天内获取免费避孕套的主要预测因素。在过去15天内，仅获取免费避孕套的女性性工作者中有67.5%的人避孕套需求得到满足，仅购买避孕套的女性性工作者中有33.8%的人避孕套需求得到满足。
四分之一的女性性工作者从未获取过避孕套，在曾获取过避孕套的人中，略超过一半的人报告在过去15天内未获取。五分之三的女性性工作者避孕套需求未得到满足。由于获取避孕套是使用避孕套的必要前提，艾滋病毒预防计划需要增加安得拉邦女性性工作者获取免费避孕套的机会。
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