Family Health International, New Delhi, India.
Sex Transm Infect. 2010 Feb;86 Suppl 1(Suppl_1):i62-8. doi: 10.1136/sti.2009.038760.
OBJECTIVE: This paper evaluates Avahan programme's coverage of female sex workers (FSWs), focus on high-risk FSWs and intermediate outcomes. METHODS: First round of cross-sectional survey data, Integrated Behavioral and Biological Assessments (IBBA), conducted in 22 districts, were aggregated into district categories: Solo, where Avahan was the sole service provider covering all FSWs and Major or Minor where Avahan was not the sole provider, but intended coverage was >50% or <or= 50% of FSWs respectively. Multivariate logistic regression was applied to compare exposure by district categories, vulnerability factors and intermediate outcomes associated with exposure. RESULTS: Reported exposure, evaluated on basis of having received any of three core services, was higher in Solo (75%) compared with Minor (66%) districts. Logistic regression showed that FSWs in solo districts were more likely to be exposed (adjusted odds ratio (AOR)=1.5; 95% CI 1.20 to 1.86) compared with FSWs in Minor districts. Multivariate analysis in Solo districts revealed that FSW with >or=15 clients in the past week had a higher chance of being exposed to core services (AOR=1.56; 95% CI 1.03 to 2.35). Exposure to the three services in Solo Avahan districts was significantly associated with correct knowledge on condom use (AOR=1.36; 95% CI 1.05 to 1.78), consistent condom use with occasional clients (AOR=3.17; 95% CI 2.17 to 4.63) and regular clients (AOR=2.47; 95% CI 1.86 to 3.28) and STI treatment-seeking behaviour (AOR=3.00; 95% CI 1.94 to 4.65). CONCLUSIONS: Higher coverage of FSWs was achieved in districts where Avahan was the only intervention compared with districts having multiple and longstanding non-Avahan programmes. Exposure in Solo districts was associated with intermediate outcomes; this need to be further evaluated in comparison with non Avahan areas and substantiated through data from next IBBA.
目的:本文评估了 Avahan 项目对性工作者(FSWs)的覆盖范围,重点关注高危 FSWs 和中间结果。
方法:对 22 个地区进行了第一轮横断面调查数据的综合行为和生物评估(IBBA),将数据汇总到地区类别中:Solo,Avahan 是唯一提供服务的地区,覆盖所有 FSWs;Major 或 Minor,Avahan 不是唯一的服务提供者,但预期覆盖范围分别为 FSWs 的>50%或<=50%。采用多变量逻辑回归比较按地区类别、脆弱性因素和与暴露相关的中间结果的暴露情况。
结果:根据接受三种核心服务中的任何一种服务,Solo(75%)地区的报告暴露率高于 Minor(66%)地区。逻辑回归显示,Solo 地区的 FSWs 更有可能接触到服务(调整后的优势比(AOR)=1.5;95%置信区间 1.20 至 1.86),而 Minor 地区的 FSWs 则没有。在 Solo 地区的多变量分析中,过去一周有>或=15 名客户的 FSW 更有可能接触到核心服务(AOR=1.56;95%置信区间 1.03 至 2.35)。在 Solo 地区,接触三种服务与正确的 condom 使用知识(AOR=1.36;95%置信区间 1.05 至 1.78)、偶尔客户(AOR=3.17;95%置信区间 2.17 至 4.63)和定期客户(AOR=2.47;95%置信区间 1.86 至 3.28)以及性传播感染(STI)的治疗寻求行为(AOR=3.00;95%置信区间 1.94 至 4.65)显著相关。
结论:与有多种长期非 Avahan 项目的地区相比,在仅有 Avahan 干预的地区,FSWs 的覆盖范围更高。Solo 地区的暴露与中间结果有关;这需要与非 Avahan 地区进行进一步评估,并通过下一次 IBBA 的数据加以证实。
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