title: Intimate relationships of Devadasi sex workers in South India: An exploration of risks of HIV/STI transmission.
abstract: Global literature on female sex workers suggests that being in an intimate relationship is associated with barriers to practising safe sex behaviours. Condom use within intimate relationships is often seen as a sign of infidelity and fosters mistrust which could affect longevity, trust and intimacy within partnerships. Using qualitative data from Devadasi sex workers and their intimate male partners in Bagalkot District, Karnataka, India, we examined both partners' perspectives to understand the quality and dynamics of these relationships and the factors that influence condom use in intimate relationships. Our thematic analysis of individual interviews conducted in May 2011 with 20 couples suggests that many Devadasi sex workers and their intimate partners define their relationships as 'like marriage' which reduced their motivation to use condoms. Evidence from this study suggests that active participation in sex workers' collectives (sanghas) can increase condom use, education and family planning services, among other things, and could be helpful for both Devadasis and their intimate partners to better understand and accept safer sexual practices. Our work has direct implications for designing couple-based health interventions for traditional Devadasi sex workers and their intimate partners in India.
authors.affiliation: a Karnataka Health Promotion Trust , Bangalore , India.
authors.forename: Satyanarayana
authors.initials: S
authors.lastname: Ramanaik
authors.forename: Laura H
authors.initials: LH
authors.lastname: Thompson
authors.forename: Elsabé
authors.initials: E
authors.lastname: du Plessis
authors.forename: Pertti
authors.initials: P
authors.lastname: Pelto
authors.forename: Vinod
authors.initials: V
authors.lastname: Annigeri
authors.forename: Mahesh
authors.initials: M
authors.lastname: Doddamane
authors.forename: Parinita
authors.initials: P
authors.lastname: Bhattacharjee
authors.forename: Souradet Y
authors.initials: SY
authors.lastname: Shaw
authors.forename: Kathleen
authors.initials: K
authors.lastname: Deering
authors.forename: Shamshad
authors.initials: S
authors.lastname: Khan
authors.forename: Shiva S
authors.initials: SS
authors.lastname: Halli
authors.forename: Robert
authors.initials: R
authors.lastname: Lorway
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007194:India; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D036301:Qualitative Research; D012309:Risk-Taking; D021841:Safe Sex / Q000523:psychology; D060386:Sex Workers / Q000523:psychology*; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D035502:Trust; D055815:Young Adult
keywords: Devadasi; HIV prevention; India; couple-based research; intimate partner