As part of the Avahan India AIDS Initiative, a behaviour change communication programme sought to increase consistent condom use CCU among male
Gautam joglekar wife sexual dysfunction of female sex workers FSWs in four Indian states through the use of outdoor static promotional materials, interpersonal communication and mid-media activities.
This paper presents key findings related to programme coverage levels, trends over time in self-reported condom use, and correlations between levels of exposure to programme activities and self-reported condom use. Five stratified two-stage cluster sample surveys were conducted between April and November sample sizes ranged from to The independent samples were composed of clients of FSWs in selected
Gautam joglekar wife sexual dysfunction. Multivariate logistic regression was used to model whether behavioural outcomes varied between baseline and endline, and whether they varied with levels of exposure the intervention.
Over two-thirds of men in each survey round recalled one or two of the
Gautam joglekar wife sexual dysfunction intervention channels. Men exposed to two intervention channels reported higher CCU than men exposed to none or only static outdoor media This trend was sustained for condom use at last sex Further research is needed on the dynamics of exposure to multiple communication channels and the contributions of complementary interventions.
India's estimated adult HIV prevalence rate is 0. Posters displayed in hotspots and point-of-purchase material at retail outlets selling condoms reinforced the themes of campaign.
Quantitative and qualitative research, Gautam joglekar wife sexual dysfunction regarding hypothesised determinants of condom use, guided messaging during the programme cycle. Further programme description can be found in the
Gautam joglekar wife sexual dysfunction web supplement. This paper addresses three questions. Second, did consistent condom use increase over time? Third, was consistent condom use associated with level of programme exposure? The study protocol was approved by an ad hoc ethical committee chaired by the Indian Council of Medical Research.
Cross-sectional surveys of clients of sex workers were conducted at hotspots across the four states in AprilDecemberMayFebruary and November States were regarded as strata, although Maharashtra was divided into two strata: Mumbai due to its size and the rest of the state.
Baseline April and endline November surveys were conducted for programme evaluation purposes, while the three intermediate rounds provided programme monitoring data. The target sample sizes for baseline and endline were individuals per round per strata ; the target sample size for monitoring was per Gautam joglekar wife sexual dysfunction per strata.
The PSUs were selected by probability-proportionate-to-size sampling; estimate of the FSW population served as a proxy since the size of the client population was unknown. In each round 30 hotspots per strata were selected; completed interview quotas were set for Gautam joglekar wife sexual dysfunction PSU.
Gautam joglekar wife sexual dysfunction necessary, the research team returned to the same site the following day to complete the assigned quota. Trained interviewers were stationed at selected points in the
Gautam joglekar wife sexual dysfunction and instructed to approach every fifth man passing by during a specified timeframe to avoid introducing selection bias based on interviewer's judgments.
Men were first read a description of the study. Those willing to participate were asked for informed consent and then were screened for eligibility.
The survey also addressed determinants of condom use; this information was used to guide programmatic decision-making. The main behavioural outcome, condom use during paid sex with an FSW, was measured in two ways: Recall was aided by showing respondents pictures of the promotional materials and activities.
Thus, respondents in all three exposure categories may have seen outdoor static media, and comparisons between exposure categories serve to highlight the contributions of IPC and mid-media channels to encouraging condom use. Only eligible men who completed the full behavioural questionnaire
Gautam joglekar wife sexual dysfunction included in the analyses.
All analyses were conducted using Stata V. Data were unweighted as estimates of client population size do not exist. Goodness-of-fit tests appropriate for survey data were performed to ensure the appropriateness
Gautam joglekar wife sexual dysfunction the models. To facilitate interpretation, OR obtained through regression models were converted into adjusted proportions, which are the expected proportions of outcome variables after controlling for differences in population characteristics.
The tests of significance are unadjusted bivariate tests. The population overall appears quite similar across survey rounds. More than three-quarters of men in all survey rounds were living with family wife or family of origin.
Gautam joglekar wife sexual dysfunction addition to FSWs, respondents had other sexual partners: Across rounds, the most common location for meeting an FSW was a brothel followed by a bus stand or railway station. Recall of IPC activities ranged from a low of Table 1 shows trends over time
Gautam joglekar wife sexual dysfunction the behaviours of interest—the composite consistent condom use variable and three component variables—after controlling for significant population characteristics.
Pairwise comparisons between baseline and endline values are presented in the final column. Among the five geographical areas, consistent condom use was the
Gautam joglekar wife sexual dysfunction at baseline in Tamil
Gautam joglekar wife sexual dysfunction at The highest consistent condom use at both baseline and endline was measured in Maharashtra, with a baseline proportion of Andhra Pradesh, consistent condom use increased from The increases in consistent condom use in all five strata were statistically significant.
Pairwise comparisons between baseline and the three exposure categories are shown, with Gautam joglekar wife sexual dysfunction significant findings indicated following the relevant endline data points.
At programme level all strata combinedconsistent condom use was significantly higher in all endline exposure categories as compared to the baseline. Condom use at last sex with an FSW was reported to be Gautam joglekar wife sexual dysfunction higher for those exposed to one or both channels at endline than for the baseline cohort.
The most notable findings for specific geographical areas are for Karnataka and Mumbai. In Karnataka, all consistent condom use endline exposure categories were significantly different from the baseline.
In Mumbai, those exposed to one or two media channels at endline registered
Gautam joglekar wife sexual dysfunction consistent condom use as compared to the baseline. Regarding the first question about levels of programme exposure, analyses reveal that exposure was considerable and sustained, with well over half of respondents in all survey rounds recalling mid-media, IPC or both, while static outdoor media was seen by at least of the sample in every round.
As for whether self-reported condom use increased over time, it is notable that condom use at last sex had a very high value at baseline PSI anticipated such high baseline measures: The composite measure of consistent condom use resulted in considerably lower baseline proportion Even assuming that social desirability bias or other self-reporting bias contributed to this result, Gautam joglekar wife sexual dysfunction increase is considerable.
The study did not employ a biological component so it is not possible to correlate reported levels of consistent condom use with levels of STI or HIV infection. In the full sample, respondents with exposure to both mid-media and IPC at endline reported significantly higher consistent condom use than Gautam joglekar wife sexual dysfunction exposed to either outdoor static media or nothing at all.
Condom use at last sex with a FSW followed a similar pattern, with exposure to IPC and mid-media correlating with a statistically significant increase in condom use but not exposure to only one channel. geographical location, Karnataka and Mumbai followed this pattern for consistent condom use and Mumbai for condom use at last sex as well.
The variability in significance at the geographic level could be a function of the smaller sample sizes.
The high baseline levels of reported consistent condom use with FSWs present both a programmatic and analytical challenge: It is of note that the findings are in line with condom use levels measured among clients of FSWs by NACO, much higher than those reported in another study in some of the same states. In the Subramanian et al study, key informants, including FSWs and local store owners, identified known clients of FSWs and then accompanied team members when they approached those men about being in the study.
That study also included a biological testing component, with consenting participants taken to a private setting where the samples were collected and the questionnaire was administered.
Since surveys with biological components are unlikely to become the norm in tracking behaviour change, it is important to measure self-reported condom use in ways that minimise the potential for over-reporting.
This study has several limitations. First, baseline values were likely influenced by more than a year of programming. Second, as exposure to the intervention was measured on the basis of a 3-month recall Gautam joglekar wife sexual dysfunction, it is not possible to assess the cumulative effect of the programme over its lifespan; thus, results observed could be due to other factors. A possibly important factor is the effect of other interventions occurring in the same
Gautam joglekar wife sexual dysfunction and same timeframe.
Third, because estimates of client population size are not available, Gautam joglekar wife sexual dysfunction could not be weighted at the analysis stage. Fourth, since data collection was confined to daylight hours, the sample may not be representative of the night-time population. Fifth, as with all studies based on cross-sectional data and self-reported behavioural outcomes, the direction of causal relationships cannot always be determined and the measures are subject to reporting errors and biases.
a geographically stable population reported consistently high exposure to the initiative over a 2. However, in the same timeframe and in the same programme areas, the availability of condoms doubled 15 and other partners of the Avahan initiative implemented programmes to increase condom use among FSWs. On the other hand, exposure to IPC and mid-media appeared to tip the balance: The positive associations programme exposure correlate with findings Gautam joglekar wife sexual dysfunction other studies—for example, Subramanian et al found that clients of FSWs were less than half as likely to report inconsistent condom use if they had been exposed to advertisements for condoms and other HIV-related interventions This study offers important lessons to
Gautam joglekar wife sexual dysfunction and evaluators of HIV prevention programmes.
First, it demonstrates the advantages of using a composite measure of consistent condom use over a single-item measure. Second, it highlights the need to better capture the effect of a programme over its lifespan as well as the synergistic effects of concurrent programmes.
To this end, better measures could be created; however, a more significant improvement would be a study design that permitted comparisons between intervention areas and control areas over time. Nevertheless, the current evaluation suggests that a behavioural Gautam joglekar wife sexual dysfunction intervention delivered at sites where FSWs are solicited can be successful in increasing consistent condom use among male clients of FSWs.
Further research is warranted to explore the dynamics of exposure to multiple behaviour change communication channels, as well the contributions of various complementary interventions in the Gautam joglekar wife sexual dysfunction goal of increasing condom use among
Gautam joglekar wife sexual dysfunction and their clients. VL developed the concept for the paper; conducted literature review; primary author of the text; provided technical input and guidance for data analyses.
AM participated in data collection and monitoring of field work; reviewer of the text; conducted preliminary data analyses. DN participated in data collection and monitoring of field Gautam joglekar wife sexual dysfunction provided support to data analyses. PM initiated quantitative surveys under the Avahan project. AS participated in data collection and monitoring of field work; provided support to data analyses. KPR participated in data collection and Gautam joglekar wife sexual dysfunction of field work; provided input into secondary literature review and conducted primary analyses for the paper.
This study Gautam joglekar wife sexual dysfunction conducted with the approval of the Indian Council of Medical Research. Provenance and peer review: Not commissioned; externally peer reviewed.
National Center for Biotechnology InformationU. Published online Feb Author information Article notes Copyright and License information Disclaimer.
As part of the Avahan India AIDS Initiative, a manners change communication syllabus sought to swelling consistent condom bring into play CCU among manful clients of female sex workers FSWs in four Indian states through the use of out of doors static promotional materials, interpersonal communication and mid-media activities. That paper presents timbre findings related to programme coverage levels, trends over however in self-reported condom use, and correlations between levels of exposure to broadcast activities and self-reported condom use.
Five stratified two-stage tuft sample surveys were conducted between April and November swatch sizes ranged from to The independent samples were composed of clients of FSWs in selected clusters. Multivariate logistic regression was used to mannequin whether behavioural outcomes varied between baseline and endline, and whether they diversified with levels of exposure to the intervention. Over two-thirds of men in each survey about recalled one or two of the main intervention channels.
Men exposed to two intervention channels reported higher CCU than men exposed to none or only static out of doors media
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She is a torrent of words and a bundle of energy. Tongue-in-cheek is her middle name. Sai Paranjpye — at her articulate and uninhibited best — in an interface with Radhika Mittal:. I can look pretty okay or look like a witch out of Macbeth! Sai Paranjpye clearly, concisely refused to be photographed for this interview. Instead, she graciously lent some precious personal photographs.
Circumstances generated through HIV Sentinel scrutiny is a national level supervision dataset and is not wide open for public access. Data can be made available upon seek after due process and inquiry can be sent to: Cross-breed sectional data collected as a part of HSS among FSWs in year —11 from 21 sentinel sites in the federal of Maharashtra were analyzed to understand the vulnerability and characteristics of different types of female sex workers based on their place of solicitation using multinomial logistic regression.
While the HIV prevalence was 6. The duration since last paid sex was shorter [ARRR: We identify them as a group to be focused on for prevention interventions and it is likely that they would be easily amenable to novel interventions due to their higher literacy rate as compared to other typologies.
India ranks third in the set in terms of HIV blight burden[ 1 ]. The Indian HIV epidemic is geographically divergent and is predominantly heterosexual. These interventions are implemented by NACP funded non-governmental or community based organizations who follow specific guidelines for provision of prevention services. However HIV prevalence in India differs by states and equable districts within states.
- â€œWe talk about sex they tell me foul jokes and sometimes I say, Theatre probably cemented her relationship with Arun Joglekar, but after two wife and mother, though Sai rues the waste of talent and Gautam as a. 3 If a girl is not the wife of the man, but is below eighteen, then the sexual intercourse .. Third case was Vinit Joglekar v Varsha Joglekar 40The wife in this case filed for Some marital rape survivors report flashbacks, sexual dysfunction , and . Grace Jayamani v E.P. Peter, AIR Kant 46 Bodhisattwa Gautam v.
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- Our study reveals that they have more frequent sex acts despite .. Mainkar MM, Pardeshi DB, Dale J, Deshpande S, Khazi S, Gautam A, et al. Brahme R, Mehta S, Sahay S, Joglekar N, Ghate M, Joshi S, et al. .. You may notice problems with the display of certain parts of an article in other eReaders.
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