HIV prevalence has gone up from 28.1% to 34.9% among female sex workers in Mumbai and a few other districts in the country, according to a study of six vulnerable Indian statesOne of the largest surveys conducted by the National AIDS Research Institute, Pune, shows that HIV prevalence among high-risk groups has generally declined, but in Mumbai and Thane, in the state of Maharashtra, and in Warangal and Visakhapatnam in Andhra Pradesh, HIV prevalence among female sex workers (FSWs) has increased.
The survey assessed the impact of Avahan, an intervention programme supported by the Bill and Melinda Gates Foundation, among high-risk groups in 29 districts of six high HIV prevalent states. The survey, carried out in two parts, covered 27,000 people in high-risk groups in 2005-07, and 25,000 people in 2009-10.
In Mumbai, female sex workers operating out of brothels showed an HIV prevalence of 28.1% in the first round, in 2005-07, and 34.9% in the second round. Among FSWs operating from the streets, the prevalence was 19.2% in 2005-07 and 32.3% in 2009-10. The corresponding rise in HIV prevalence for female sex workers in Thane was from 18.6% to 33.1% for those working from brothels, and from 7% in the first round to 11.8% for FSWs on the street.
The survey found that prevalence among men having sex with men in Mumbai went down significantly from 12.3% to 3.4%, but in Guntur, Hyderabad, Chennai and Coimbatore it increased. Prevalence also climbed among drug users in Manipur, from 32.2% in the first round to 39.9% in the second round, though it dropped from 16.5% to 14.8% among drug users in Mumbai and Thane.
One of the findings of the survey is that condom use is as high as 95% among FSWs for occasional partners, but they did not use condoms with regular partners.
The Avahan project, launched in 2003, is one of the largest intervention programmes in the field of HIV/AIDS in India. According to its website, it provides monthly prevention services to over 220,000 female sex workers, 80,000 high-risk men who have sex with men and transgendered people, 18,000 injecting drug users, and 5 million men at risk along the nation’s major trucking routes.
It works in six states: Tamil Nadu, Karnataka, Andhra Pradesh, Maharashtra, Nagaland, and Manipur, covering 82 districts and 605 towns. Avahan also works along 8,000 kilometres of national highway to reach highly mobile interstate truckers who account for approximately 10-12% of the female sex workers’ clients.