S. Thilakavathi|Boopathi Kangusamy|CP Girish Kumar|Santhakumar Aridoss|R. Senthilkumar|C Eswaramurthy|V Ilaya Bharathy|Lakshmi Ramakrishnan|Gay Thongamba|Rajatashuvra Adhikary|Ramesh Paranjape
Assessment of the scale, coverage and outcomes of the Avahan HIV prevention program for female sex workers in Tamil Nadu, India: is there evidence of an effect?
National Institute of Epidemiology|National Institute of Epidemiology|National Institute of Epidemiology|National Institute of Epidemiology|National Institute of Epidemiology|National Institute of Epidemiology|National Institute of Epidemiology|National Heart Institute|National Heart Institute|National Heart Institute|National AIDS Research Institute
avahan india aids initiative largescale hiv prevention program using peermediated approaches sti services implemented highrisk groups hiv six states india paper describes assessment program among female sex workers fsws southern state tamil nadu analytical framework based avahan impact evaluation design used routine program monitoring data two rounds crosssectional biological behavioural surveys among fsws 2006 round 1 2009 round 2 quality assessments clinical services sexually transmitted infections stis used assess trends coverage condom use prevalence stis hiv association program exposure logistic regression analysis used examine trends intermediate outcomes associations intervention exposure avahan program tamil nadu scaled achieved monthly reported coverage 79 within four years implementation crosssectional survey data showed increasing proportion fsws reached avahan 54 round 1 86 round 2 aor47p0001 quality assessments sti clinical services showed consistent improvement quality scores 30 2005 45 2008 condom distribution program rose cover estimated commercial sex acts reported consistent condom use increased round 1 round 2 occasional 72 93 aor55 p0001 regular clients 68 89 aor43 p0001 reactive syphilis serology declined significantly 97 22 aor02 p0001 hiv prevalence remained stable 61 rounds strong association avahan exposure consistent condom use commercial clients however association seen declines stis avahan program tamil nadu achieved high coverage fsws resulting outcomes improved condom use declining syphilis stabilizing hiv prevalence expected outcomes following program logic model declining hiv prevalence among general population groups suggest potential impact high risk group interventions hiv epidemic tamil nadu