title: Female sex worker's participation in the community mobilization process: two distinct forms of participations and associated contextual factors.
abstract: BACKGROUND
  Community mobilization is a participatory intervention strategy used among Female Sex Workers (FSW's) to address HIV risks through behavior change and self empowerment. This study quantitatively measure and differentiate theoretically defined forms of FSW participation's and identify their contextual associated factors.
  
  
  METHODS
  Data was derived from cross-sectional Integrated Bio Behavioral Assessment conducted among FSW's in Andhra Pradesh (AP) (n = 3370), Maharashtra (MH) (n = 3133) and Tamil Nadu (TN) (n = 2140) of India during 2009-2010. Information's about socio-demography, community mobilization and participation experiences were collected. Conceptual model for two contexts of mobilization entailing distinct FSW participations were defined as participation in "collective" and "public" spaces respectively. Bivariate and multiple regression analysis were used.
  
  
  RESULTS
  The level of participation in "collective" and "public" spaces was lowest in MH (43.9% & 11.7% respectively), higher in TN (82.2% & 22.5% respectively) and AP (64.7% & 33.1%). Bivariate and multivariate regression analysis highlighted the distinct nature of "participations" through their varied associations with FSW mobilization and background status.In MH, street FSWs showed significantly lower collective participation (36.5%) than brothel FSWs (46.8%) and street FSWs showed higher public participation (16.2%) than brothel FSWs (9.7%). In AP both collective and public participation were significantly high among street FSWs (62.7% and 34.7% respectively) than brothel FSW's (55.2% and 25.4% respectively).Regression analysis showed FSWs with "community identity", were more likely to participate in public spaces in TN and AP (AOR 2.4, 1.5-3.8 & AOR 4.9, CI 2.3-10.7) respectively. FSWs with "collective identity" were more likely to participate in collective spaces in TN, MH and AP (AOR 27.2 CI 13.7-53.9; AOR 7.3, CI 3.8-14.3; AOR 5.7 CI 3-10.9 respectively). FSWs exhibiting "collective agency" were more likely to participate in public spaces in TN, MH and AP (AOR 2.3 CI 1-3.4; AOR 4.5- CI 2.6-7.8; AOR 2.2 CI 1.5-3.1) respectively.
  
  
  CONCLUSIONS
  Findings reveal FSWs participation as a dynamic process inherently evolving along with the community mobilization process in match with its contexts. Participation in "Collective" and Public spaces" is indicators, symbolizing FSWs passage from the disease prevention objectives towards empowerment, which would help better understand and evaluate community mobilization interventions.
authors.forename: Karikalan
authors.initials: K
authors.lastname: Nagarajan
authors.affiliation: National AIDS Research Institute- ICMR, 73, G Block, Pune, Bhosari 411026, India. ssahay@nariindia.org.
authors.forename: Seema
authors.initials: S
authors.lastname: Sahay
authors.forename: Mandar K
authors.initials: MK
authors.lastname: Mainkar
authors.forename: Sucheta
authors.initials: S
authors.lastname: Deshpande
authors.forename: Sowmya
authors.initials: S
authors.lastname: Ramesh
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Paranjape
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D015438:Health Behavior; D006801:Humans; D007194:India; D011209:Power, Psychological; D012111:Residence Characteristics; D012306:Risk; D011477:Sex Work; D060386:Sex Workers; D055815:Young Adult