Samvedana Plus: Reducing violence and increasing condom use in the intimate partnerships of female sex workers.
Karnataka Health Promotion Trust is implementing Samvedana Plus with 800 female sex workers and their intimate partners, in partnership with Chaitanya AIDS Tadegattwa Mahila Sangha, a community-based organisation (CBO) of sex workers in northern Karnataka, India. The programme runs with support from the United Nations Trust Fund to End Violence Against Women (UNTF), What Works to Prevent Violence against Women and Girls consortium and the University of Manitoba. Within DFID –funded STRIVE consortium, KHPT and the London School of Hygiene and Tropical Medicine are evaluating the impact.
Bagalkot district, North Karnataka, India
Summary of Intervention / Research
Samvedana Plus is an intervention and evaluation study to understand and address violence and HIV risk amongst the intimate partnerships of female sex workers. The intervention works at three level: Individual level (FSWs and IPs); CBO and Community with effective strategies to shift social norms, challenge gender roles and prevent violence against women. The evaluation employs a cluster-randomised control trial design, including quantitative baseline, midline and endline assessments amongst FSWs, and baseline and endline assessments with their IPs; qualitative, longitudinal case studies with FSWs and their IPs; in-depth interviews with facilitators of the programme, and implementation monitoring. The study is investigating the relationship between social norms and HIV risk in the context of sex workers’ intimate partnerships and assess the efficacy of the intervention in modifying these norms.
The project will run over 3 years and end line results are expected in the first quarter of 2018
A Facilitators’ Guide for Training Female Sex Workers
The response to the HIV epidemic through targeted interventions focused largely on changing individual behaviour and encouraged female sex workers to use condoms correctly, continuously and consistently with their clients. However, subsequent studies reported that although condom usage during sexual interactions with clients increased, their usage was less consistent with intimate partners (also known as lovers and as Hiriya or Malak in the context of Karnataka) of female sex workers. It was also observed that where condom use has been inconsistent, experience of violence has been high.
Samvedana Plus - Implementation Design
The influence of structural factors such as poverty, social norms, alcohol abuse, and criminalisation of high-risk behaviours on HIV risk and vulnerability has led scholars and HIV prevention programmers to regard structural intervention as an essential component of an HIV prevention strategy. Structural interventions reduce risk and vulnerability among female sex workers (FSWs) by empowering them with greater control over condom use with clients, and reducing violence and stigma against them.
A Facilitators’ Guide for Training Intimate Partners of Female Sex Workers
In response to the HIV epidemic, targeted interventions were initiated which focused on changing individual behaviour and encouraging sex workers to use condoms correctly, continuously and consistently with their clients. However it was observed in subsequent studies that though there was an increase in condom usage among sex workers during their sexual interactions with clients, the usage was less consistent when they were with their intimate partners (termed lovers in some contexts or Hiriya or Malak in the context of Karnataka).
Raghavendra Thalinja, Project Director, Karnataka Health Promotion