Available evidence nevertheless suggests that compared with standard care or no intervention, behavioral interventions are effective in reducing HIV and the incidence of STIs amongst female sex workers (FSWs). Given the benefits of social cognitive theory and the promotion of condom use in reducing HIV/STI and the public health need to control transmission amongst FSWs, there is a clear finding in favour of behavioral interventions. However, it should be recognized that there is a lack of information about most other outcomes and target populations, and that all of the trials were conducted in low- and middle-income countries.
HIV prevention among sex workers in India.
To test the efficacy of a sustainable community-level HIV intervention among sex workers, the Sonagachi Project was replicated, including community organizing and advocacy, peer education, condom social marketing, and establishment of a health clinic. Sex workers were randomly selected in 2 small urban communities in northeastern India (n = 100 each) and assessed every 5-6 months over 15 months (85% retention). Overall condom use increased significantly in the intervention community (39%) compared with the control community (11%), and the proportion of consistent condom users increased 25% in the intervention community compared with a 16% decrease in the control community. This study supports the efficacy of the Sonagachi model intervention in increasing condom use and maintaining low HIV prevalence among sex workers.