Police violence and female sex work in south India

Change over time in police interactions and HIV risk behavior among female sex workers in Andhra Pradesh, India.

Erausquin JT, Reed E, Blankenship KM. AIDS Behav. 2015 Jun;19(6):1108-15. doi: 10.1007/s10461-014-0926-5.

Little is known about the effectiveness of intervening to change interactions between female sex workers (FSWs) and police in order to reduce HIV risk. Using data collected in the context of a HIV prevention intervention that included components to change policing practices (n = 1680), we examine the association of FSWs' reports of negative police interactions and HIV risk behaviors and whether these associations varied over time. Results show negative police interactions declined significantly over time. FSWs who had more than one negative police interaction were more likely to experience STI symptoms (AOR 2.97 [95 % CI 2.27-3.89]), inconsistently use condoms with their clients (AOR 1.36 [95 % CI 1.03-1.79]), and accept more money for condomless sex (AOR 2.37 [95 % CI 1.76-3.21]). Over time, these associations were stable or increased. Even where interventions have reduced the number of police incidents experienced by FSWs, stakeholders in HIV prevention must remain vigilant in challenging these incidents.

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Editor’s notes: Laws relating to sex work are frequently ambiguous. This allows considerable police discretion about who to arrest and under what charges. Bribes and arrest both have real monetary costs for female sex workers, who are already usually economically vulnerable. Financial pressure and or poverty can push women into agreeing to riskier sex with riskier clients in riskier places. This paper examined if negative police experience is associated with increased HIV risk behaviours; and if negative police experience changed over time following comprehensive HIV prevention programming.

The study found negative police interactions in the previous six months were frequent. Police raided workplace (36.1%), police arrested respondent (14.5%), police accepted bribe or gift so respondent could avoid trouble (14.8%), police had sex with respondent so she could avoid trouble (11.1%) and police took condoms away (7.6%). Negative police interactions were linked with an increased HIV risk including STI symptoms in the past 12 months; inconsistent condom use with clients in the past seven days and accepting more money for sex without a condom. However, there was a reduction over time in the proportion of women experiencing one or more negative police interactions in the past six months (21.2% versus 16.2%).  Risk behaviours also reduced over time.

This study adds to emerging literature that it is possible to intervene against violence exposure and negative police interaction as part of HIV prevention programming. It also underscores the importance of structural drivers in enhancing HIV risk among female sex worker populations.

Asia
India
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