Factors associated with numbers of client partners of female sex workers across five districts in South India.
BACKGROUND
This study investigated the structural-environmental and individual-level social factors associated with the numbers of commercial sex clients of female sex workers (FSWs) per month (CPM).


METHODS
Data were analyzed from cross-sectional surveys of FSWs in 5 districts in Karnataka state, India (2004-2005). Bivariate and multivariable negative binomial regression models with generalized estimating equations were constructed for each district. Normalized weights were used to account for complex sampling design.


RESULTS
Median (average) CPM varied significantly (P < 0.001) across districts, from 40.0 (56.9) CPM in the district with the highest immunodeficiency virus prevalence (33.9%) to 16.0 (26.1) in the district with the lowest prevalence (9.7%). In multivariable analysis, there was a significant positive association between rates of CPM and sex work as sole income in 4 districts (adjusted incidence rate ratios, AIRR: [95% confidence intervals]: AIRR: 1.3 [1.0-1.7], P < 0.005-1.7 [1.2-2.5], P < 0.01); age, typology (place of solicitation), and marital status were significantly associated with CPM in 3 districts, with an inverse association between age and CPM (P < 0.01). FSWs soliciting clients in brothels had higher rates of CPM than home-based FSWs in 2 districts (AIRR: 1.5 [1.1-2.0]-1.6 [1.0-2.7], P < 0.05), whereas public places-based FSWs had higher rates in 1 district (AIRR: 1.4 [1.1-1.8], P < 0.01); cohabiting FSWs had higher rates than married FSWs in 3 districts, whereas single FSWs had higher rates in one district.


CONCLUSIONS
These results provide support for the continued development of structural core group interventions that address common elements of sex work placing FSWs at higher risk for immunodeficiency virus, as well as geographically focused programs that account for local differences in sexual structure.
School of Public and Population Health, University of British Columbia, James Mather Building, 5804 Fairview Ave, Vancouver, British Columbia V6T1Z3, Canada. kdeering@cfenet.ubc.ca
Kathleen N
KN
Deering
Mark W
MW
Tyndall
Jean
J
Shoveller
Stephen
S
Moses
James F
JF
Blanchard
Souradet
S
Shaw
Banadakoppa M
BM
Ramesh
Shajy
S
Isac
Marie-Claude
MC
Boily
D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners