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Implementing sexual health promotion with rural sex work communities in Rajasthan, India.


Int Conf AIDS. 1998;12:1025-6 (abstract no. 60142). Unique Identifier :

OBJECTIVES: To assess the impact of Contextual factors in relation to behaviour change among the rural sex workers. DESIGN: Gram Bharti Samiti, an Indian rural development organisation has been working with International Family Health, a British based development NGO, to implement a holistic sexual health programme for tribal sex work communities in Rajasthan. An important aspect of the programme has been its focus on contextual factors impacting on behaviour change, condom use, social stigma and the improvement of quality of life. The need to move from traditional individualistic health belief models of health promotion is often stressed in the HIV/AIDS field, but the process of implementing a structural change model is rarely discussed. METHOD: The non-traditional health promotion strategies used have included poverty reduction, provision of clean water, legal representation and beautician training. Challenges faced include client violence against workers, Police and Pimp harassment, workers being arrested and land rights disputes. RESULTS: The implementation of structural change interventions have taught both organisations of the importance of staff selection and support, sex work communities support of workers, the need to gain community credibility (and the time that takes) and that changing power dynamics meets resistance at unexpected levels and impacts on community dynamics both internally and externally. CONCLUSION: Health promotion needs both structural and interpersonal interventions, however the instigation of structural change is rarely discussed. This programme has learnt from facing the challenges of implementing both within traditional tribal communities and other stakeholders for those communities, in particular in coping as "agitators" to allow power to shift within those groups.

MEETING ABSTRACTS Acquired Immunodeficiency Syndrome/*PREVENTION & CONTROL/ TRANSMISSION Cultural Characteristics *Developing Countries *Health Plan Implementation *Health Promotion Human India Knowledge, Attitudes, Practice Medicine, Traditional *Prostitution *Rural Population Sexually Transmitted Diseases/*PREVENTION & CONTROL/TRANSMISSION


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