Kathleen Deering|Marie?Claude Boily|Catherine M Lowndes|Jean Shoveller|Mark W. Tyndall|Peter Vickerman|J.E. Bradley|Kaveri Gurav|Michael Pickles|Stephen Moses|Banadakoppa M Ramesh|Reynold Washington|S Rajaram|Michel Alary
A dose-response relationship between exposure to a large-scale HIV preventive intervention and consistent condom use with different sexual partners of female sex workers in southern India
University of British Columbia|Imperial College London|University of British Columbia|University of Ottawa|London School of Hygiene & Tropical Medicine|Centre Hospitalier Universitaire de Québec|Karnataka Health Promotion Trust|Imperial College London|University of Manitoba|Karnataka Health Promotion Trust|Karnataka Health Promotion Trust|Karnataka Health Promotion Trust|Université Laval
avahan initiative largescale hiv preventive intervention targeted highrisk populations including female sex workers fsws initiated 2003 six highprevalence states india including karnataka study assessed intervention exposure associated condom use fsws sexual partners including doseresponse relationshipdata crosssectional study 200607 775 fsws three districts karnataka survey methods accounted complex cluster sampling design bivariate multivariable logistic regression used separately model relationships five intervention exposure variables five outcomes consistent condom use ccu always versus frequentlysometimesnever different sex partners including clients occasional clients recent repeat client recent nonpaying partner husband cohabiting partner linear tests trends conducted three continuous intervention exposure variablesfsws reported highest ccu clients 817 ccu lowest fsws husband cohabiting partner 96 multivariable analysis odds ccu clients occasional clients 63fold 95 confidence intervals cis 28145 23fold 95 cis 1441 higher among fsws contacted intervention staff 49fold 95 cis 2693 23fold 95 cis 1341 higher among ever observed condom demonstration staff respectively compared significant doseresponse relationship existed ccu outcomes increased duration since first contacted staff p0001 p0006 numbers condom demonstrations witnessed p0004 p0026 doseresponse relationship also observed condom use clients number times contacted staff p0047 intervention exposure associated higher odds ccu recent repeat client recent nonpaying partner husband cohabiting partnerstudy findings suggest exposure largescale hiv intervention fsws associated increased ccu commercial clients moreover doseresponse relationships ccu clients increased duration since first contacted staff times contacted staff number condom demonstrations additional program effort required increase condom use noncommercial partners