Regional Office, India HIV AIDS Alliance, Sarovar Centre, 5-9-22, Secretariat Road, Hyderabad-500063, Andhra Pradesh, India.
J Epidemiol Community Health. 2012 Oct;66 Suppl 2:ii62-68. doi: 10.1136/jech-2011-200832. Epub 2012 Apr 6.
To assess the association between female sex workers' (FSWs) degree of community collectivisation and self-efficacy, utilisation of sexually transmitted infection (STI) services from government-run health centres in Andhra Pradesh, India.
Cross-sectional analyses of 1986 FSWs recruited using a probability-based sampling from five districts of Andhra Pradesh during 2010-2011. Multiple logistic regression models were constructed to assess associations. The independent variables included-collective efficacy, collective agency and collective action-measured using a series of items that assessed the grouping of the community on issues that concern most sex workers. An additional independent variable included FSWs belonging to an area where there was a project partnership with government health centres to provide STI treatment services to FSWs. The outcome indicators included self-efficacy for service utilisation from government health facilities and the treatment for STIs from government health facilities at least once in the past year experience of STI symptoms.
Of the 1986 FSWs, nearly two-fifths (39.5%) reported a high level of overall collectivisation (collective efficacy: 89%, collective agency: 50.7%; collective action: 12.7%). Sex workers with a high degree compared with low degree of overall collectivisation were significantly more likely to report high self-efficacy to use government health facilities (75.0% vs 57.3%, adjusted OR 2.5, 95% CI 2.0 to 3.1) and to use government health centres for STI treatment in past 1 year (78.1% vs 63.2%, adjusted OR 2.1, 95% CI 1.6 to 2.8), irrespective of project partnership with government centres.
The current research findings reinforce the need for stronger community mobilisation for better utilisation of government health facilities for STI and HIV prevention interventions.
评估印度安得拉邦女性性工作者（FSWs）的社区集体化程度与其自我效能感之间的关联，以及她们对政府运营的性传播感染（STI）服务中心的利用情况。
2010 年至 2011 年期间，采用概率抽样方法从安得拉邦五个地区招募了 1986 名 FSWs，进行了横断面分析。使用一系列评估社区在最关心性工作者的问题上的分组的项目来构建多逻辑回归模型，以评估相关性。自变量包括使用社区集体效能、社区机构和集体行动来衡量，这三个指标是评估社区在最关心性工作者的问题上的分组情况的。另一个自变量包括性工作者所在的地区是否与政府卫生中心合作开展项目，以向性工作者提供 STI 治疗服务。结果指标包括从政府卫生机构获得服务的自我效能感，以及过去一年中至少一次因 STI 症状而在政府卫生机构接受治疗的经历。
在 1986 名 FSWs 中，近五分之二（39.5%）报告了高度的整体集体化程度（社区集体效能：89%，社区机构：50.7%；集体行动：12.7%）。与低度整体集体化程度相比，高度集体化程度的性工作者更有可能报告高度使用政府卫生机构的自我效能感（75.0%比 57.3%，调整后的 OR 2.5，95%CI 2.0 至 3.1），以及在过去一年中因 STI 症状而在政府卫生中心接受治疗的经历（78.1%比 63.2%，调整后的 OR 2.1，95%CI 1.6 至 2.8），无论是否与政府中心开展合作项目。
当前的研究结果强调了需要加强社区动员，以更好地利用政府卫生设施进行 STI 和 HIV 预防干预。
