title: Increases in self-reported consistent condom use among male clients of female sex workers following exposure to an integrated behaviour change programme in four states in southern India.
abstract: OBJECTIVE
  As part of the Avahan India AIDS Initiative, a behaviour change communication programme sought to increase consistent condom use (CCU) among male clients 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.
  
  
  METHODS
  Five stratified two-stage cluster sample surveys were conducted between April 2006 and November 2008 (sample sizes ranged from 1741 to 2041). The independent samples were composed of clients of FSWs in selected clusters. Multivariate logistic regression was used to model whether behavioural outcomes varied between baseline and endline, and whether they varied with levels of exposure to the intervention.
  
  
  RESULTS
  Over two-thirds of men in each survey round recalled one or two of the main intervention channels. An increase in CCU with FSWs was found between baseline and endline (63.6% vs 86.5; p<0.01). Men exposed to two intervention channels reported higher CCU than men exposed to none or only static outdoor media (89.4% vs 82.0%, p<0.05). This trend was sustained for condom use at last sex (96.2% vs 92.6%, p<0.05).
  
  
  CONCLUSIONS
  Evaluation suggests that a multi-channel behavioural intervention delivered at sites where FSWs are solicited can increase CCU among male clients of FSWs. Further research is needed on the dynamics of exposure to multiple communication channels and the contributions of complementary interventions.
authors.affiliation: Population Services International, Research Department, Washington, DC, USA.
authors.forename: Varja
authors.initials: V
authors.lastname: Lipovsek
authors.forename: Amajit
authors.initials: A
authors.lastname: Mukherjee
authors.forename: Deepa
authors.initials: D
authors.lastname: Navin
authors.forename: Pritpal
authors.initials: P
authors.lastname: Marjara
authors.forename: Aseem
authors.initials: A
authors.lastname: Sharma
authors.forename: Kali Prosad
authors.initials: KP
authors.lastname: Roy
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007194:India; D008297:Male; D015397:Program Evaluation; D021841:Safe Sex / Q000706:statistics & numerical data*; D011477:Sex Work / Q000706:statistics & numerical data*