title: Violence and HIV risk among female sex workers in Southern India.
abstract: BACKGROUND
  This study characterized the type and frequency of violence against female sex workers (FSWs) perpetrated by their clients and their main intimate or other nonpaying partner (NPP) and examined the relationship between violence and inconsistent condom use (ICU, G100%). The factors associated with client violence were also assessed.
  
  
  METHODS
  Data were analyzed from cross-sectional surveys of FSWs in Karnataka state (2007-2008), India. Multivariable logistic regression was used to assess the following: (1) relationship between client or NPP violence (physical and/or sexual) and ICU by occasional/repeat clients or the NPP and (2) relationship between social and environmental factors and client violence.
  
  
  RESULTS
  Of 1219 FSWs, 9.6% (111) and 3.7% (42) reported experiencing violence by clients and the NPP, respectively. In multivariable analysis, after adjusting for social and environmental factors, the odds of ICU by occasional clients were significantly higher for women who had experienced client violence (adjusted odds ratio [AOR], 2.7; 95% confidence interval (CI), 1.6-4.4). Similar results were found with repeat clients (AOR, 2.2; 95% CI, 1.4-3.4). Nonpaying partner violence was not significantly associated with ICU by the NPP. In multivariable analysis, only being recently arrested remained significantly associated with experiencing client violence (AOR, 1.8; 95% CIs, 1.0-3.3).
  
  
  CONCLUSIONS
  The findings from this study provide evidence of a relationship between experiencing client violence and ICU by occasional and repeat clients, and a relationship between being arrested and client violence. Comprehensive structural/policy programming for FSWs, including within HIV-focused prevention programs, is urgently needed to help reduce FSWs' vulnerability to violence
authors: Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada. kdeering@cfenet.ubc.ca
authors: Kathleen N
authors: KN
authors: Deering
authors: Parinita
authors: P
authors: Bhattacharjee
authors: H L
authors: HL
authors: Mohan
authors: Janet
authors: J
authors: Bradley
authors: Kate
authors: K
authors: Shannon
authors: Marie-Claude
authors: MC
authors: Boily
authors: B M
authors: BM
authors: Ramesh
authors: Shajy
authors: S
authors: Isac
authors: Stephen
authors: S
authors: Moses
authors: James
authors: J
authors: Blanchard
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D007398:Interpersonal Relations; D016017:Odds Ratio; D018570:Risk Assessment; D011477:Sex Work / Q000706:statistics & numerical data*; D060386:Sex Workers; D012725:Sexual Behavior; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data*