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Community advocacy groups as a means to address the social environment of female sex workers: a case study in Andhra Pradesh, India
  1. Swarup Punyam1,
  2. Renuka Somanatha Pullikalu1,
  3. Ram Manohar Mishra2,
  4. Prashanth Sandri1,
  5. Balakrishna Prasad Mutupuru1,
  6. Suresh Babu Kokku1,
  7. Prabhakar Parimi1
  1. 1India HIV/AIDS Alliance, Hyderabad, India
  2. 2Population Council, New Delhi, India
  1. Correspondence to Dr Swarup Punyam, India HIV/AIDS Alliance, Sarovar Center, 5-9-22, Secretariat Road, Hyderabad 500063, Andhra Pradesh, India; pswarup{at}


Background To examine the association between the presence of community advocacy groups (CAGs) and female sex workers' (FSWs) access to social entitlements and outcomes of police advocacy.

Methods Data were used from a cross-sectional survey conducted in 2010–2011 among 1986 FSWs and 104 NGO outreach workers from five districts of Andhra Pradesh. FSWs were recruited using a probability-based sampling from 104 primary sampling units (PSUs). A PSU is a geographical area covered by one outreach worker and is expected to have an active CAG as per community mobilisation efforts. The presence of active CAGs was defined as the presence of an active committee or advocacy group in the area (PSU). Outcome indicators included acquisition of different social entitlements and measures of police response as reported by FSWs. Multivariate linear and logistic regression analyses were used to examine the associations.

Results Areas with active CAGs compared with their counterparts had a significantly higher mean number of FSWs linked to ration cards (12.8 vs 6.8; p<0.01), bank accounts (9.3 vs 5.9; p=0.05) and health insurance (13.1 vs 7.0; p=0.02). A significantly higher percentage of FSWs from areas with active CAGs as compared with others reported that the police treat them more fairly now than a year before (79.7% vs 70.3%; p<0.05) and the police explained the reasons for arrest when arrested the last time (95.7% vs 87%; p<0.05).

Conclusion FSWs from areas with active CAGs were more likely to access certain social entitlements and to receive a fair response from the police, highlighting the contributions of CAGs in community mobilisation.

  • Structural interventions
  • sex workers
  • HIV prevention intervention
  • community advocacy
  • social capital
  • empowerment
  • HIV
  • AIDS
  • public health
  • violence
  • epidemiology
  • statistics

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  • Funding Support for programme implementation was provided to the India AIDS Alliance via a grant from the Bill & Melinda Gates Foundation through Avahan, the India AIDS Initiative. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Bill & Melinda Gates Foundation and Avahan.

  • Competing interests None.

  • Ethics approval Ethical committee of Family Health International and the Karnataka Health Promotion Trust.

  • Provenance and peer review Commissioned; externally peer reviewed.

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