INFORMED CONSENT FOR FEMALE SEX WORKERS
Namaste! My name is Manisha Gore. First I would like to thank you for sparing your time to talk with me.
Purpose of the study: I am a Ph.D. student from University of Pune, Pune. I am working on “<4 Study of Condom Non Use by Brothel Based Female Sex Workers in Budhwarpeth, Pune- An Anthropological Perspective". The objective of this study is to gain knowledge on brothel based female sex workers attitudes towards condom use what she exactly feel about condom use. The study will try to understand what are her knowledge about condoms and to gain a deeper insight into the difficulties and barriers she is facing in condom use with all of her clients. This study would help in better understanding of sexual behavior of brothel based female sex workers through their emic view which would be helpful in planning future intervention strategies for female sex workers to prevent HIV/AIDS
The results of this survey will be used only for my Ph.D. thesis submission. Your thoughts are very important and I really appreciate your help. You have been selected in this study just by chance and not for any reason. I am going to conduct several interviews like this one in next few weeks.
Your participation in this study: You would participate in this study only if you want and you can withdraw at any time from this study. This interview will take about 45 minutes. You will not be compensated for your time and effort.
If you consent, then you will be asked some detailed questions about yourself, such as your age, marital status, residence, your knowledge and attitudes towards condom use, the barriers and difficulties you are facing in condom use with all your clients and regular partners. Your honest answers will help this study to better understand sex workers behavior regarding condom non-use. Some of these questions might sound embarrassing to you, and you may choose not to answer any question if you do not want to. You are requested not to discuss the questions asked as part of this survey with your fellow sex workers.
Page 1 of 2 Confidentiality: I assure you that everything you say here will remain completely confidential.
Nothing you say will be linked to your full name in any way. The specific content of what you say will not affect your personal relationship with any organizations, associations, or individuals from
your workplace, or outside your workplace. I will give copy of this consent form if you wish.
Queries related to the study: If at any time you have any questions or concern you can call my
Ph.D. guide Dr. Sanjay Juvekar 09881057959, Pune.
Voluntary consent: I have read this consent fonn completely / this consent fonn has been read
out to me. All my doubts have been cleared. I can withdraw my participation anytime, if I feel so.
I have understood this. I have been promised that my personal information shall be kept
confidential.
I want to participate in this study myself by my own free will and am willing to (Circle number
that is accepted):
1. Participate in the interview
I have been offered a copy of my consent form and (Circle number that is accepted):
1. I want a copy of my consent form
2. I don’t want a copy of my consent form
Signature of the respondent:______Date:.
Signature of the interviewer:______Date:.
Page 2 of 2 SECTION I: INTERVIEW INFORMATION # OMtOon Answer Code S H ito Code Box 101 Name and code of Interviewer □C Name
102 Date of interview Date (DD/MM/\ Y
103 Brothel Site Name of the Lane Name of the Building No of the Brothel 104 Language of the interview Hindi 01 Marathi 02 □[ Other (Specify) 96 105 Completion status Selected respondent was not available 01 ► END □[ Completed interview 02 ► END Did not complete interview 03
To be completed by Supervisor at the END of interview
106 Was the entire questionnaire No 00 □[ checked for consistency and Yes 01 errors? 107 These responses have been scrutinized for completeness and consistency by: Name of Supervisor Date checked Signature of Supervisor b. Day c. Mo d. Yr a. Code of Supervisor □□ □□ □□ □□
SECTIONH: SOCIO DEMOGRAPHIC PROFILE OF THE RESPONDENT
# Question Answer Code Skip to Code Box 201 What is your ethnicity ( Needs to a. Maharashtra 01 reframe question) b. Nepali 02 c. Bengali 03 d. Karnataka 04 e. Andhra Pradesh 05 f. Other specify 06
202 How old are you? Age in completed years □[ Don’t know 95 203 Can you read and write? Cannot read and write 01 □[ Can read only 02 Can read and write 03 Have you ever attended school? 204 Yes 01 No 02
205 What is the highest level of PRIMARY 01 school you completed; ? SECONDARY 02 HIGHER 03 No RESPONSE 09 How long have you lived here in 206 NUMBER OF YEARS [ _ | 1 Budhwarpeth? □c
207 What is name of your Brothel Owner? Name of Brothel Owner
208 For how long have you been staying Number of Days with this brothel owner?
Where else did you do sex work 209 Name of the place before coming to this area? □[ No Response 99
210 What is your marital status? Never married 01 □c Currently married 02 Deserted / separated / divorced 03 Widowed - living alone 04 Widowed - living with partner 05 211 What is your current living Living with husband 01 arrangement? □[ Living with partner (other than husband) 02 Living without husband with parents/children 03 Living without husband with relatives Living with friends 04 Living in brothel 05 Living alone 06 Other (Specify) 07 96 212 How many children do you have? a. # of male chUdren aD[ b. # of female children No children 97 ^ Skip to bD[ 214 213 How many of them are below the age of a. # of male chUdren 12? aQ[ b. # of female children bD[ 214 Gynecological History a. # of Dresnancv a n b. # of live births c.# of abortions till now bQ[
215 .# of abortions in last one vear
216 Where is your native place? Name of native place
217 How many times in a year do you travel No of times to your native place?
01 218 Do you migrate or change your place of Yes sex work? 02 No
219 If yes how many times in a year? No of times in a yr.
220 Where do you migrate? Name o f place
215 Do you own any of the following: Yes No aQ[ a. Cooking gas 01 00 b. Refrigerator 01 00 uD nrUL c. Radio 01 00 d. Television 01 00 c f f e. Mobile phone 01 00 f Vehicle (motorcycle, 01 00 dD[ scooter, car) g. House/land 01 00 eD[ h. Livestock 01 00 i. Savings 01 00 fD[
g Dl
hnc
iUL
SECTION III: OCCUPATIONAL QUESTIONS 301 Where do you generally solicit/pick up Brothel 01 most of your clients? Budhwarpeth Street 02 Contacted by phone 03 Do not read responses. Select only one response. Through pimps/middlemen 04 Other (Specify)______05 No Response 96
302 Do you go for night out to provide Yes 01 service to clients NO 02
303 In a month how many times do you No of times • go for night out?
304 How old were you when you started Age in completed years sex work? Don’t remember 98 305 The first time you sold sex, were you No 00 forced or coerced by any person to do so? Yes 01 No answer 99 306 If the answer is no ’ in 305: No money to meet basic expenses 01 Under what circumstances did you first To earn quick/more money 02 sell sex? To supplement family income 03
Instruction: To meet immediate medical or other 04 exigencies in family or for herself Mark only one main reason. Let the respondent answer spontaneously. To earn money to repay debt 05 Check the option that is thematically To continue with the family tradition of 06 closest to the respondent’s answer. selling sex Probe only if the respondent is not forthcoming. Other (Specify)______96 No answer 99 307 If the answer is '^es ’ in 305: Was deceitfully brought to a brothel 01 Under what circumstances did you first Was forcibly brought to a brothel sell sex? Was forced by husband/family members 02 to earn money by selling sex Instruction: 03 Was pressurized / had to pay back Mark only one main reason. Let the someone with sexual favour respondent answer spontaneously. 04 Check the option that is thematically Other (Specify)______closest to the respondent's answer. No answer 96 Probe only if the respondent is not forthcoming. 99
308 If the answer is ‘OT or ‘OT in 307: Husband alone or with others 01 Who was mainly responsible for Boy friend alone or with others 02 introducing you into sex work? Other family members/relatives 03 Known family fnend 04 Known local goon______05 Unknown outsider 06 Female friend/acquaintance 07 Independent decision 08 Other (Specify)______96 No answer 99 309 If the answer is W ’ in 307: Employer/overseer/labour 01 Who did you pay back in terms of contractor/employment agent sexual favor? Local goon 02 Local leader 03 Police 04 Family member/relative 05 Government official 06 Other (Specify)______96 No answer 99
Now I would like to ask some questions about your sexual practices and some general questions about your work. I once again assure you that all this information will be kept fully confidential. SECTION IV; SEXUAL BEHAVIOUR AND PRACTICES Skip # Question Answer Code Code Bo: to ALL PAYING CLIENTS (OCCASIONAL AND REGULAR)
401 On an average, how many days in a # of days in a week □[ week do you usually work as sex D on ’t remember 98 worker?
402 On an average, how many clients do # of clients in a week □[ you usually serve in a week? D o n ’t remem ber 98
403 Do you practice sex work at night also Yes 01 □[ No 02 404 If yes how many hours during night? No of hours
405 On an average, how many sexual # of sexual encounters in a week □C encounters you have with your clients 98 in a week? D on ’t remember 406 On an average, how much do you charge for each sexual encounter? Average amount (Rs.)
407 Are there certain weeks/months Y es. M ore 01 during the year when you entertain Y es, Less 02 more or less clients than that? Yes - Both More and Less 03 N o 00 D o n ’t know 98 N o answer 99
408 Are there different types of sexual 01 encounters practiced in your area? Yes
02 N o 409 If Yes what are they
410 DO the charges differ on basis of the 01 □[ encounters? Yes
02 N o 411 What are charges? A verage amount ( R s ) ......
412 Do the charges also differ on basis of 01 □[ condom use? Yes
02 N o 413 For an encounter without condom how □ c much are the clients willing to pay Average amount ( R s) ------more than the encounter with condom use?
414 Do the charges also differ for oral and 01 □[ anal sex? Y es
02 N o 415 What are the charges? Avg amount Oral S ex ...... -
Avg amount Anal Sex
V-ONE-TIME/OCCASIONAL CLIENTS (who pay every time but you do not know them at all) Do you have occasional clients? 501 Y es 01 □ c N o 02
502 How many times did you have sex a. # in the last working day a DC (oral/penetrative) with a one-time/ 98 occasional client in the: D o n ’t remember bDC a. last working day? b. # in the last seven working 98 b. last seven working days? days Don’t remember 503 The last time you had sexual No 00 intercourse with an occasional client, Yes 01 □C 98 did he use a condom? Don’t know/ Don’t remember 99 No answer 504 Usually, how often do you and your Every time 01 one-time/occasional clients use a Most of the time 02 condom while having sex? Sometimes 03 Never 04 505 Do you apply condom to your one 01 time/occasional clients ? Yes
No 02 506 How often do you apply condom to Every time 01 vour one-time/occasional clients ? Most of the time 02 Sometimes 03 Never 04 507 For how long have you and your one Duration (in months) time/occasional clients been using a condom every time? 508 In the last one week, how often have Every time 01 you used condoms with your Most of the time 02 occasional clients? Sometimes 03 04 Never 96 Did not have any occasional client in 98 the last week 99 Don’t know
No answer 509 In the last one month, how often have Every time 01 you used condoms with your Most of the time 02 occasional clients? Sometimes 03 04 Never 96 Did not have any occasional client in 98 the last week 99 Don’t know
No answer 510 The last time a condom was not used Client did not want to 01 with vour one-time/occasional client. I did not want to 02 what was the main reason? Condom was not available 03 Condom costs too much 04 I was intoxicated 05 Other (Specify) 96
511 Do you use double condoms with your Every time 01 □ [ one-time/occasional clientsl Most of the time 02 Sometimes 03 Never 04 512 Would you be willing to use a female No 00 □[ condom with a one-time/occasional Yes 01 client? Maybe 02 Already do 03 Don’t know what female condom is 97 513 Can you tell me, during the past one All 01 week, how many of your occasional clients did you urge to use condoms? Most 02 READ ALL RESPONSES AND Some 03 CIRCLE THE ONE SELECTED None 04 BY RESPONDENT Did not have any occasional clients 98 in past one week 05 No VA- REGULAR CLIENTS (who visit repeatedly and who pay every time they have sex with you; you know them well and recognize them) 501 Do you have regular clients? Yes 01 □[ No 02
502 How many times did you have sex a. # in the last working day aQ[ (oral/penetrative) with a regular client 98 in the: Don’t remember b n c a. last working day? b. # in the last seven working 98 b. last seven working days? days Don’t remember 503 The last time you had sexual No 00 intercourse with an regular client, Yes 01 □C 98 did he use a condom? Don’t know/ Don’t remember 99 No answer 504 Usually, how often do you and your Every time 01 □C regular clients use a condom while Most of the time 02 having sex? Sometimes 03 Never 04 505 Do you apply condom to your regular 01 Yes □C clients ? No 02
506 How often do you apply condom to Every time 01 □[ vour regular ? Most of the time 02 Sometimes 03 Never 04 507 For how long have you and your regular clients been using a condom Duration (in months) every time? 508 In the last one week, how often have Every time 01 you used condoms with your Most of the time 02 □l Sometimes 03 regular clients? 04 Never 96 Did not have any occasional client in 98 the last week 99 Don’t know
No answer 509 In the last one month, how often have Every time 01 you used condoms with your Most of the time 02 □[ regular clients? Sometimes 03 04 Never 96 Did not have any occasional client in 98 the last week 99 Don’t know
No answer 510 The last time a condom was not used Client did not want to 01 □[ with vour regular client, what was the I did not want to 02 main reason? Condom was not available 03 Condom costs too much 04 I was intoxicated 05 Other (Specify) 96 511 Do you use double condoms with your Every time 01 □[ regularl clients^ Most of the time 02 Sometimes 03 Never 04 512 Would you be willing to use a female No 00 □[ condom with a regular client? Yes 01 Maybe 02 Already do 03 Don’t know what female condom is 97 513 Can you tell me, during the past one All 01 week, how many of your occasional Most 02 clients did you urge to use condoms? 03 READ ALL RESPONSES AND Some CIRCLE THE ONE SELECTED None 04 BY RESPONDENT Did not have any occasional clients 98 in past one week 05 No V- B NON-PAYING REGULAR PARTNERS (who visit repeatedly but do not pay to have sex with you; this category includes HUSBANDS. BOYFRIENDS and OTHER LIVE-IN PARTNERS) 501 Do you have non- paying regular Yes 01 partners? No 02
502 How many times did you have sex a. # in the last working day (oral/penetrative) with a non-paying 98 regular partners in the: Don’t remember a. last working day? b. # in the last seven working b. last seven working days? 98 days____ Don’t remember 503 The last time you had sexual No 00 Intercourse with an non -paying Yes 01 98 regular client did he use condom ?, Don’t know/ Don’t remember 99 No answer 504 Usually, how often do you and your Every time 01 non paying regular partner use Most of the time 02 condoms? Sometimes 03 Never 04 505 Do you apply condom to your non 01 paying regular partners^ Yes
No 02 506 How often do you apply condom to Every time 01 non paying regular partners ? Most of the time 02 Sometimes 03 Never 04 507 For how long have you and your non paying regular partner’s been using a Duration (in months) condom every time?______508 In the last one week, how often have Every time 01 you used condoms with your Most of the time 02 Sometimes 03 non paying regular partners? 04 Never 96 Did not have any occasional client in 98 the last week 99 Don’t know
No answer 01 509 In the last one month, how often have Every time you used condoms with your Most of the time 02 non paying regular partners? Sometimes 03 04 Never 96 Did not have any occasional client in 98 the last week 99 Don’t know
No answer 510 The last time a condom was not used Client did not want to 01 with your non paying regular partners, I did not want to 02 what was the main reason? Condom was not available 03 Condom costs too much 04 I was intoxicated 05 Other (Specify)______96
511 Do you use double condoms with your Every time 01 non paying regular partners ? Most of the time 02 Sometimes 03 Never 04 512 Would you be willing to use a female No 00 condom with a non paying regular Yes 01 partners ? Maybe 02 Already do 03 Don’t know what female condom is 97 Can you tell me, during the past one 513 All 01 week, how many of your non paying regular partners Most 02 did you urge to use condoms? Some 03 READ ALL RESPONSES AND None 04 CIRCLE THE ONE SELECTED Did not have any occasional clients 98 BY RESPONDENT in past one week 05 No V-C OTHE] R NON-PAYING PARTNERS (who do Blot pay to have sex with you; this category includes GOONS POLICE, PIMPS, OTHER BOYFRIENDS, etc.) 501 Do you have other non -paying Yes 01 □C partners? No 02 502 How many times did you have sex a. # in the last working day a o : (oral/penetrative) with a other non 98 paying partners in the: Don’t remember bDC a. last working day? b. # in the last seven working 98 b. last seven working days? days Don’t remember 503 The last time you had sexual No 00 Intercourse with an other non-paying Yes 01 98 partners did he use a condom? Don’t know/ Don’t remember 99 No answer 504 Usually, how often do you and your Every time 01 □[ other non-paying partners use a Most of the time 02 condom while having sex? Sometimes 03 Never 04 505 Do you apply condom to your other 01 □[ non-paying partners? Yes
No 02 506 How often do you apply condom to Every time 01 other non-paying partners? Most of the time 02 Sometimes 03 Never 04 507 For how long have you and your other □n: non-paying partners been using a Duration (in months) condom every time? 508 In the last one week, how often have Every time 01 you used condoms with your other non Most of the time 02 □[ Sometimes 03 paying partners? 04 Never 96 Did not have any occasional client in 98 the last week 99 Don’t know
No answer 509 In the last one month, how often have Every time 01 you used condoms with your other non Most of the time 02 □c Sometimes 03 paying partners 04 7 Never 96 Did not have any occasional client in 98 the last week 99 Don’t know
No answer 510 The last time a condom was not used Client did not want to 01 with your other non-paying partners, what was the main reason? I did not want to 02 Condom was not available 03 Condom costs too much 04 I was intoxicated 05 Other (Specify)______96
511 Do you use double condoms with your Every time 01 other non-paying partners? Most of the time 02 Sometimes 03 Never 04 512 Would you be willing to use a female No 00 condom with a other non-paying Yes 01 partners? Maybe 02 Already do 03 Don’t know what female condom is 97 513 Can you tell me, during the past one All 01 week, how many of you other non paying partners did you urge to use Most 02 condoms? Some 03 READ ALL RESPONSES AND NoneNone 04 CIRCLE THE ONE SELECTED Did not have any occasional clients 98 BY RESPONDENT in past one week 05 No VI ALL CLIENTS/PARTNERS 601 The last time you used a condom with No 00 any client/partner, did you experience Yes 01 condom breakage? Don’t remember 98 602 In the past month, have you No 00 had the experience of a condom Yes 01 96 breaking while it was being Did not use a condom in 98 used? past one month 99 Don’t know /Don’t remember No answer 603 Of the last ten clients/partners you # of clients/partners have had sex with (/penetrative), how Don’t remember 98 many brought their own condoms? 60 4 The last time you used a condom I did on my own during sex (/penetrative) with any I asked client/partner to put it on client/partner, who put on the condom? Client/partner did on his own Client/partner asked me to put it on Have never used a condom 97 605 Are you carrying a condom with you No 00 right now? Yes, could show condom 01 (ask to show the condom) Yes, could not show condom 02 606 What is your main source of Peer educator 01 condoms? Field officer 02 NGO office 03 Condom vending machine 04 Pan shop/grocery shop 05 Bar/lodge/hotel/dhaba 06 Madam 07 Client 08 Friend 09 Hospital/dispensary/clinic 10 Pharmacy/medical shop 11 Never obtained 97 Other (Specify)______96 607 Would you be interested in purchasing No 00 condoms if no free condoms are Yes 01 available? Maybe 02 Already do 03
Had you ever heard of 701 No 00 HIV/AIDS before this interview? Yes 01 From which sources of 702 Radio A information have you learned about HIV/AIDS? Television B Instruction: Cinema C M ultiple answ ers possible. N ewspapers/magazines D Posters/hoardings E Exhibition/mela F Government health workers G NGO workers H Adult education programme I Religious leaders______J Political leaders K School/teachers L Community meetings M Regular partner/husband/boyfriend N Friends/relatives O Work place P Other (Specify) 96 Don’t know 95 No answer 99 703 Do you personally know No 00 □[ someone (who also knows you) who is infected with HIV, Yes 01 suffers from AIDS or has died No answer 99 of AIDS? 704 Do you agree with the Agr Disagr Don’ following statements? ee ee t a □[ kno b □[ w a. The presence of an STI cQ[ increases the risk of 01 00 95 infection of HIV/AIDS dQ[ b. HIV and AIDS are the 01 00 95 same eG[ c. STIs always have 01 00 95 symptoms fa d. A healthy looking gQ[ person can have 01 00 95 HIV/AIDS e. HIV can be transmitted 01 00 95 through anal sex f. HIV/AIDS can be transmitted from a 01 00 95 mother to her baby g. HIV/AIDS can be 01 00 95 cured 705 Do you agree that the Agr Disagr Don’ following methods can prevent ee ee t aDE a person from becoming kno bQ[ infected with HIV/AIDS? w a. Avoiding the use of c □[ shared clothes or eating 01 00 98 utensils dDL b. Eating nutritious food 01 00 98 c. Always using a eD[ condom while engaging 01 00 98 in sex fQ[ d. Avoiding mosquito or 01 00 98 other insect bites e. Taking medicines or traditional herbal 01 00 98 mixtures before having sex f. Avoiding the use of 01 00 98 shared injection needles For the first time fi-om which 706 Peer Educators 01 source you came to know about condoms? Television Advertisement 02 Newspapers 03 Colleague sex workers 04 Client 05 Any Other Source 99
707 Do you know how to use Yes 01 condoms? No 02
708 Who has taught you to use Peer Educators 01 condoms? Colleague Sex Workers 02 Brothel Owner 03 Doctor 04
709 Have you been exposed to Yes 01 condom demonstration? No 02
If yes by whom ? 710 Peer Educators 01 Fellow Sex Workers 02 Brothel Owner 03 Clinic Doctor 04 Counselor 05 7 11 There are eight steps to using 1 Tear along one side of the foil, being condoms. The following are 10 statements about using a sure not to rip the condom inside condom some of which are 2 Put the condom on anytime before you correct and some of which are ejaculate. incorrect. Circle the eight correct statements. 3 Put the condom on when the penis is Identify Correct Steps with erected, before there is any contact help of the pictures. between the penis and your partner’s body ( With Pictures)______4 Unroll the condom before placing on the penis 5 Withdraw the penis while it is still erected by holding the condom firmly in place. Remove the condom 6Unroll the condoms to approximately three quarters of the way down the penis 7 Squeeze the closed end of the condoms between your forefinger and thumb and placed the condom over the erected penis SUnroll the condom to the base of the penis 9Withdraw the penis after it is no longer erected by holding the condom firmly in place remove the condom. 10 dispose the condom taking proper care.
712 Do you also know that condom Yes use can prevent unwanted 01 pregnancy?______No 02 7^3 Do you know that condom use Yes 01 also prevent fi'om other STIs infections apart from HIV? No 02
How do you store condoms? 714 Don’t Know 99 Do you know how to discard 715 Yes 01 condoms? □C No 02
716 If Yes How? □[
Apart from freely distributed 717 Yes 01 condoms do you know any □[ other socially marketed No 02 condoms? 718 If yes tell me the name of the some of the socially marketed □[ condoms?
Do you know the costs of the 719 Yes 01 socially marketed condoms? □[ No 02
720 Do you use double condom? Yes 01 □[ No 02
721 If yes why? Clients demand for 01 □ [ It is safe 02 Fear of breaking single condom 03
Do you know about Female 722 01 Condoms? Yes □ [ No 02
For the first time from which 723 Peer Educators 01 source you came to know about Female Condoms? Television Advertisement 02 □ □ □ □ [ Newspapers 03 Colleague sex workers 04 □ □ c Client 05 Any Other Source 99
Do you know how to use 720 Yes female condoms? 01 skip □ c No 02 □[
Who has taught you to use 718 Peer Educators Female Condoms? 01 □ c Colleague Sex Workers 02 Brothel Owner 03 Doctor 04
Have you been exposed to 719 Yes 01 Female Condom □[ Demonstration? No 02
720 If yes by whom? Peer Educators 01 □[ Fellow Sex Workers 02 Brothel Owner 03 Clinic Doctor 04 Counselor 05 Are female condoms freely 721 Yes 01 distributed to you? □[ No 02
722 Do you buy female condoms? Yes 01 □[ No 02
What is the cost of the female 723 Cost condom? □[
Are you in favor of using 724 Yes 01 female condoms over male □C condoms? No 02
725 If yes why ? □[
726 If no why ? □[
727 Where would you go for Govt hospital/ICTC (VCTC) A □[ HIV/AIDS testing? NGO clinic B Private doctor/lab C Instruction: Other (Specify) 96 Multiple answers possible 728 Have you ever taken an HIV/ No 00 □[ AIDS test? Yes 01 No answer 99 729 When did you last take an Less than a year ago 00 □[ HIV/ AIDS test? More than a year ago 01 Don’t remember 98 No answer 99 730 Did you collect the test result? No 00 □E Yes 01 Instruction: No answer 99 Explain that the interviewer does not want to know the test result
731 Are there are any drugs that No 00 l1 JLj|“ can help treat people who have Yes 01 AIDS? Dont know 95 No answer 99
732 Have you ever heard of ART? No 00 □l Yes 01 Dont know 95 No answer 99 801 Do you communicate about condom Yes 01 use with clients while solicitation? No 02 802 If yes why?
803 If No Why?
804 Does a client often demand sex Yes 01 without condoms? No 02 805 If yes do they give reasons for it? Yes 01 No 02 806 What reasons they give you for not using condoms? 807 Do you feel condoms reduce pleasure Yes 01 while having sex? No 02 808 Have you been forced to have sex with Yes □ r clients without condoms? No 809 If Yes By whom?
810 In your tiny compartment are you Yes 01 comfortable in applying condoms to No 02 the partner? 811 If no what are the difficulties you faced in the encounter room with respect to condom application? 812 In a day how many drunken clients have sex with you? No of Clients 813 How many drunken clients do you entertain at night No of Clients 814 Does the drunken client use condom 01 with you ? Yes 02 No 815 If no what are the difficulties you face with drunken clients? 816 Till now have you been faced by any violent act from client for insistence Yes for use of condom? No 817 What kind of violence you faced?
818 By Whom ?
819 Have you experienced client loss in 01 □ n : last one month because of insistence of Yes 02 condom use ? No 820 How many clients refuse you because No of clients □ c you insist for condom use in last one month? 821 What was the amount of loss of Rs income you faced in last month 822 Is it necessary for you to earn a fixed Yes 01 amount daily? No 02
823 If yes than to earn that much amount No of clients □c of money how many clients you have to entertain?
824 What do you do if you fail to get those □l numbers of clients?
825 Are your family members Yes 01 □l economically dependent on you? No 02
826 How much money do you send to your family members monthly?
827 Till now has it happened that you did Yes 01 not use condoms because it was not No 02 available with you in past one/three months? 828 How frequent do you have on spot Every time 01 sexual encounters with any client? Most of the time 02 Sometimes 03 Never 04 829 Do you use condoms in such Yes 01 encounters? No 02
827 If no why ?
828 Have you experienced any kind of Yes 01 physical discomfort because of use of No 02 condoms with clients? 829 If yes what type of physical discomfort have you experienced?
830 Are you happy with the lubrication of Yes 01 □l condoms? No 02
831 How do you personally like sex With Condoms 01 Without Condoms 02 832 Do you enjoy sex with your Yes 01 RP/BF/Husband No 02
833 Does your RP/BF/Husband prefer to Yes 01 use condoms with you? No 02
834 If no why RP/BF/Husband do not use She feels that RP would show 01 condoms with you? Mistrust 02 Loves RP so do not want to use 03 condoms 04 He feels that you are infected with STI/HIV 05 You feel he might be infected with 06 STI/HIV 07 Wants to conceive from RP Wants to enjoy sex with RP Mutual Trust
835 Have you experienced any kind of Yes 01 violence/Physical/Verbal Abuse from No 02 your RP/BF/Husband in last six months for insistence of condom use by you ?______836 If yes what ?
837 Do you use double condoms with your Every time 01 main non-pavim regular partner? Most of the time 02 Sometimes 03 Never 04 838 Would you be willing to use a female No 00 condom with your main non-pavins Yes 01 resular partner? Maybe 02 Already do 03 Don’t know what female condom is 97 901 Do you consume the Yes No No Ans following substances? 01 00 99 a. Alcohol ► X if b. Gutka/tambaku 01 00 99 ‘no’ pan/khaini/mishri or ‘no c. Bidi/cigarette 01 00 99 ans’ to aU d. Sleeping pills 01 00 99 e. Brown Sugar 01 00 99 f. Ganja 01 00 99 g. Other drugs 0 00 99 902 How often do you One At consume these At e in Lea substances? Leas Mor S t No Dai t e Neve One an One Tha r ly e/M s eAV n a ont eek Mon h t h a. 01 02 03 04 05 99 Alcohol b. Gutka/ 01 02 03 04 05 99 ambaku pan/ khaini/mi shri c. 01 02 03 04 05 99 Bidi/cigar ette d. 01 02 03 04 05 99 Sleeping pills e. Brown 01 02 03 04 05 99 Sugar f. Ganja 01 02 03 04 05 99 g. Other 01 02 03 04 05 99 drugs Scale
S1_I feel I can comfortably put condom on my client
S2_Condoms are used only to prevent pregnancy,it does not have any other uses
S3_Condoms are not required with other contraception method e.g. copper-t, pills etc. is used NS
S4_l needn?t use condom with the clients appearing to be in good physical health as they cannot have HIV/AIDS
S5_I think that condoms are not needed during anal or oral sex
S6_I feel, I can make unwilling clients willing to use condom
S7_I think that condoms do not easily tear/slip off during sexual intercourse
SS Sometimes, 1 do not use condom with a client because I don?t have it
S9_I feel, it is uncomfortable to negotiate condom use with client in open (road/market place)
S10_If I refuse to have sex without condom then brothel owner or client may harm me
SI I Female sex worker with positive results should always use condom
S12 I think if I insist on condom use then I will lose my clients and it will significantly affect my earning but still my health is a priority
S13_Under influence of alcohol or drug a client?s risk taking behavior increases
SH Once tested negative for HIV means I needn?t use condom anymore
S15_I feel I can confidently talk about condom use with my clients
S16 I can get infected with HIV/AIDS even if I am consistent in condom use
S17_I think that most of the clients are often in hurry and don?t have time for condoms
518 I should also use condom with my regular partner
519 I feel, I can easily say no to sex if any client refuses to use condom ( even if he offers extra money for sex without condom)
520 I think that if I use condom with my regular partner/lover or husband he may doubt my health or character
521 I think clients do not feel embarrassed to use condom S22_Some clients do not feel that condom make sex less pleasurable hence they don?t want to use it
S23_Now a days, clients are aware enough to use condoms
S24_Condom use prevents HIV/STI Transmission i€ 3iTM)$^cr^ti a i f ^ 'i B S h T ^ R ^ 3 T ^ « m « «^Aw
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JfoRT J 7 ^ ^ 3imw mv 3m wr^ ^ • Charges negotiated by FSW with clients? • Reasons for variation in charges ? • Any particular experience regarding sex work which you would like to share with me? 2. What was the first source of information about condom use to you? q M iiiT * Wit # 5n5R»ifr 3im>r ^ ^ fJr;#r ? 3. Who taught you about condom use? ^ Wit # olM4>l(1 ? 4. Are you aware that consistent condom use with all types of clients prevents HIV/AIDS? 3im ?r q«TT ^ ^ wit ^ n if d f ?rm endftv ^sitr ^ airr ttet 3inr 5. Do you perceive the risk of getting infected with HIV/AIDS? If yes why? If no why? ?nraT f^sjnr^iftTrjrainre^t ^ ^rk tt f i 3rit ft ^ 3lk at ^ ? 6. Are you aware that FSW are vulnerable towards getting Infected with HIV/AIDS ? If yes why? If no why? W TRT 3*^ ^ ^ arnr s^t T ?^ # crJn?[T StTTT ^ 3HIT fT c^r ^ 3ftr 51^ tfr ^ ? 7. What Is your perception abb(Jt Insistence of condom use with clients? ^ ^ wit # ^ ? 8. Is condomuse dependent on types of clients entertained? If yes why? If no why? wzn ^ ^TT2T, cfSl^d % q r ^ t ? 3T^ flT cfT ^ ? 9. Any barriers In negotiating condom use with clients? ^ Tim ^ Wit ^ ^ ^ ft^IcT 3ITcft 10. Which are the common barriers experienced by FSW in soliciting condom use with clients? 9ST 3fr ^ l i t # ?3rr 3Tnr ^ fw m 7 11. Could you please describe in detail the barriers experience by FSW in using condom with clients? 12. What are the reasons of non use of condoms among FSW with clients? <4-HI$d ^ 5IT *FROT ^ ? 13. Do FSW often experience symptoms of STIs such as lower abdominal pain, white discharge and ulcers? ^ xnir w 5«^ ?i»r ^]m ^ a4»cflM» ^ f ? 3PTT FT eft ^ ? 14. What are the possible reasons for experiencing the symptoms of STIs? ^ « 15. Have you experienced any one of the symptoms of STIs in last six months? 16. Usually, from where do you seek treatment If you suffer from any symptoms of STIs? Why? sm ?T. aiTT t ^ ^ ? 17. FSW often have unintended pregnancies whicli leads to induced abortions, why? ^ 3Rrar#f ^ ^ ^ R r i ^ ^ 35^ qsHT ^ xnn ? Alcoholism in Female Sex Workers and Clients, Barrier In Practice of Safe Sex, a Study on Fsws of Red Light Area of Pune City M.mish.i N Goie‘, Saiijay K Juvek.ir ‘Doctoral Studait, Department of Aiitliropologi/, Saritrshai Phiile Ufi/ifrs/fy of Pune, Ganeohkhmd, Pune, •Ph D Guide, Dq’artment of Anthropologi), Sai'itrilKii Pliiile Pune Unnrrsiti/, KEM Hospital Research Centre, Pune ABSTRACT Backgiouiid: Alcohol use by female sex ^^/o^kers (FSWs), sexual ei\counters »vith dm nkeii clients mcrease nsk of unsafe sex As part of Ph D study, kno\vledge, attitudes towards condom use and bamers such as proportion of FSWs dru^king alcohol, dnuiken clients entertamed and their association ivith consistent condom use beha\ior w as analyzed m FStVs of red light area of Pune cit\v Method: Mixed methods were used 80 FSWs ivere selected by 2 stage cluster sampling method, follo»ved by purposive selection 20 FSVVs for in depth intervieivs Results: (55“o) of FSWs were alcohol drinkers, of which (8S.t»3*o) »vere daily drmkers and (47 5%) FSVVs entertamed drunken clients There was significant association betiveen percentage of FSVVs drinkmg alcohol and consistent condom use beha\ior (p<0 03 Conclusion: Icohol use m FSVVs is a barrier in adoptmg safe sex beha\ior Kei/wonis: Alcohol Lbe, Comistmt Contiotn Ihe INTRODUCTION , working for FSVVs in Karnataka reported that m Karnataka, 60 % of FSVVs can be termed as alcoholics Sex work has social characteristics thi/t contour, and the rest as occasional drinkers'*' A study in drinkmg Sexual encounters under mnuen'ce of Mumbai revealed (11%) alcohol-dependent Hl\' alcohol use bv (FSVVs) or client's are closely associated mfected FSVVs '’i with nsk\' behavior of unprotected sex than the frequeno,- or quantit',’'*--’*’ Globally, bam ng variations In Scotland (bO**o) FSVVs' reported entertairung in drinking patterns m Nairobi Kenya, Guyana, South drunk client In Philippines37®o were reported having Africa and North America studies ha\’e documented sex witli intoxicated chents and32% m Beijmg reported high proportion of FSVVs drinking alcohol'*' In China, clients drinking during sex Among re\’iexved studies, 50“o adolescent sex \>rarkers ha\-e sexual encounters a high proportion (14-38%, median 66%) of male in drui\ken state '’'In India a National Beha\'ioral clients engaged in sexual acti\it\- were under the Sur\-eillance Survey conducted in 2001 and 200b u\fluence of alcohol in India, Netherlands, Nortliem reported overall (20^o) of FSVVs consummg alcohol everyday during last 4 weeks in 2b states The Ireland and Thailand '“'and this was corroborated by proportion was highest m Onssa (5<>%), followed by another study in India, which reflected that(58“o) of Andhra Pradesh (44%), Delhi (36%), M anipur (36%) clients used alcohol during at least five of their past 10 In Nagaland it was found that (20^o) FSVVs ivere sexual encounters''”' In National Behavioral regular drinkers'^.whereas m district of Bellar\'m Sun'eillance Sui\-ey of 200b,India documented 1,^4“' Karnataka (40 %) of FSVVs \vere alcoholics ' ,an NGO of clients(25.8%)of total sample reporting Indian Journal Public Health Ju-stnrrfi & Diwlopmcnt Apnl-Jum' 1015 Vol 6. No 2 333 consurnption of alcohol datly. »vhile (31“o) reported qualitative data were analyzed using inductive drinking infrequently before sex'*' approach Transcripts ivere read and re- read to develop an initial coding scheme and emerging themes Several studies from loiv- and middle-income were consolidated Statistical package of SPSS 20 was countries reported positive associations befiveen used for quantitative anal\-sis Quanhtati\'e data were alcohol use and 'unprotected sex' (e g no use, anal\-zed by descriptive statistics, chi square test was inconsistent use or incorrect use of condom) in daily applied for significant association behveen variables FSVV druxkers in Nairobi, Ken\-a, and those ha\-ing Alcohol consumption by F5\Vs for the study 'vas sex »vith intoxicated clients in Philippines, Smgapore, considered as e\-er alcohol use by FSWs m last one Papua Ne'v Gumea and India'“ A study on migrant month precedmg sur\-ey The main outcome indicator FSWs and chents from 4 high HI\’ pre\-alence states for this study was operationally defmed as consistent depicted sigmficant associahon bet^veen alcohol condom use, ^vhich is correct and consistent condom consumpbon prior to sex \vitl\ inconsistent condom use for e\-er\- sex act 'vith all t\pes of clients by FSWs use <“' m last one month precedmg sur\’ey (fa) Studies have explored reasons of alcohol use ui Ethical Appioval FSWs such as decreased inhibitions prior to sex work, to cope with stigma of bemg FSW, psychological The study protocol and informed consent form distress, clients preference for drunk FSWs, \vere appro\-ed by the Ethics Committee of Savitribai copmg mechanism m response to stressful ivorkmg Plmle, Uruversit;,' of Pxme Prior to data collection, condition, self medication, victimization of sexual I'/ntten informed consent) ivas obtained from FSWs violence All necessary steps were followed to maintain confidenhabtv’ of FSWs As part of this Ph D study, FSWs kno%vledge about coiidom use and attitudes towards condom use were R E S iaT S studied Understandmg different barriers in condom use was one of the primary- objectives »vhere we Socio Demographic Results determined the proportion of FSWs consuming (1.1 )A total of 30 female sex w orkers consented and alcohol, number of drunkei\ clients entertamed and completed the sur\’ey Tlie mean age of FSWs was its association with consistent condom use beha\ior 2 Table 1 Disttibution o i ies|>ondents by social Table 3 Disliibution ot FSWs response on number ot d em o g iap lu c p fo tile 1.1 Age m Andhra Pradesh 18 22.5 (T1 (137SS) nj^Vs do not do sex work at n i^ t) O thers b 3 Total 80 100 Association behveen \ ’ariable N Percent «t«i> FSVS^ drtnkwtf »ka^ol IH iMth Proportion ot FSWs drinking alcohol cor mt«nt co«t Once m a m«r»th 2 4.5 Cemtsum cendem um Total 44 100 2 •! FSWi •! r* Diunken clients entertained by FSWs during day and n ig h t !«. •/J ■M More than half (47.5%) FSWs reported all clients /• I entertained by them are drunk during day time, CCU (43.3%) reported entertaining during m CCUM mght (23 8®o)entertain 2-3 drunken chents during day as compared to (13 3%) dunng night (2.5 %) reported *>• a • of entertammg 4-5 drunken clients durmg day (5®o) N*. reported entertammg tlie same number dunng night (Mntt Indian loiinm! cf Public Health K.-50iich & Dcivtopmait ApriJ-fiinc 2015, Vol 6. No 2 335 Themes emeiged tioiu qualitative data - reasons toi Alcohol consumption and its association with alcohol use. practice of safe sexual behavioi Personal crisis: 4 FSWs shared due to depression Studies have revealed significant association because of expeneiice of persoi\al tragedies such as behveen FSWs dnnkm g habit and practice of safe sex broken relationships/' deiection from regular partners/ behavior Migrant FSWs from Andhra Pradesh and bov fnends, disclosure of sero positiv e status; hence to Kerala, practice of drmkmg alcohol in context of sexual cope ivith the circumstances the\’ started drmking act IS significantly assoaated ^vith inconsistent condom alcohol use'**'.Perilous drinkers were prone to higher mcidences of unprotected sex, which was associated ("I Hsnf to drink prei'iouslif, but not so frcqucntlit with s\-mptoms of STIs' ’ “ "’.FSWs \vho were daily m y iru s U'hcn I lost 2 ifrs daughter, thcpnin nnbcnrnbic drinkers from Nairobi, Kenya and binge drinkers m ------, I started drinking regularly" Mombasa, dnnkm g before sex or having sex with ------23%t s ------FSW) mtoxicated chents m the Pluhppmes reported positi\"e Piofessional ieason:To endure the stress of sex associations between alcohol use and "unprotected ^vork 5 FSWs \-oiced out tliat drinking alcohol ease sex"'*-*'*' the pain of entertainiixg clients, tliey can take extra More than half (47.5%), (43 8^o) FSWs reported of clients which brmg more moiie\-,3 FSWs reported : use entertainmg drunken clients durmg day and mght of alcohol before sexual encounters attracts clients, tmie In a shidy in Zimbab've > 50®o of FSWs reported the\' are happy when FSWs gives tliem company for that their most recent client was inebriated dnnkmg alcohol "Lifestiflcs in hrotheh are frustrating Significant association was not found with number of by because of lack of basic amenities leading to alcohol use drunken clients entertamed and consistent condom use ------^------30 y r F S W 2 F S W s FSWs" by FSWs On contrar\', in India (Mumbai) a study expressed their relatives and native people have foimd that m en's hea\-\’ alcohol use was significantly abandoned them from the community’ because they associated »vith m consistent coiidom use over the last are FSWs, to forget hurruhations tlie\’ started drmkmg year; a co m p arab le a sso c iah o n w a s n o t seen m FSWs'^’ alcohol FSWs in Cambodia identified alcohol intoxication Consuming alcohol and practicii\g sex work is a (FSWs and clients), as key barriers in successful big barrier m condom use 8 sex workers ccnifessed that negotiation of condom use'*^ dnnkm g alcohol and entertaining cUents durmg mght The qualitati\’e aspect of the study highlighted and at wee hours could lead to ui\safe sex (tlie sex reasons for drmking alcoltol among FSWs personal 'vorker would not be m position to apply condom to and professitmal These fmdmgs are supported by the clients, clients would refuse to wear a condoni), other studies ^vherein FSWs consunie alcohol for self- drunk clients tear/pull out condoms and behave medication, to cope with economic problems, depm-ed violently witli FSWs life st\'le and stressful \srork, stigma associated with sex work, fear of abusive cUent, un^vanted pregnancies DISCUSSION and STIs, conflicts with colleague sex workers, brothel managers, clients, poUce, to put aside their negative Proporhon of FSWs dnnkmg alcohol m the study feelmgs, reduce anxiet\' about makmg contact and were fotmd to be more than half (55%) from red light o\-ercome ph\’sical a\’ersion for their clients area, majontv’ of which (‘JO P°o) are drinking regularly. Studies have revealed that (74 3%) FSWs in Nairobi, Overall the abo\’e discussion confirms wide spread Kenya, (20'^o) m South Africa, (34 5%) m Guyana, alcohol use in FSWs and their clients which is (b7.8%) in Nigena were consummg alcohol and these positively associated with unprotected sex The fmdings corroborates high percentage of alcohol use q u a litatn 'e a sp ect affirm s th e fm d m g s fro m tlie sur\*ey. m FS W s'' . In In d ia stu d ie s fro m N a g a la n d , B ellarv, Tl\e Imutations are, the study have not attempted to K arn ata k a reflected (20“o-40“o) alcohol d e p e n d e n c\- in \'ie'v m detail FSWs pattern of dnnkmg alcohol m FSWs hi Andhra Pradesh, Kerala the percentage was tem \s of quantitN’, context of alcohol use m relation to (53 8“o) In M u m b a i (1 l “b) o f H I \’ infected FSW s w e re sexual act The sample size ( N=80) is calculated as alcohol dependent i’ • 336 /fiiiwH loiinial of Public Health Rt'search & Dcivlopmcnt April-Juw 2015. Vol 6. No 2 per the obiectives ot the Ph D study which tvcruld be National Aids Control Orgamzation, National insufficient to emphatically justify- the results related Behavioral Sur\-eillance 5ur%-ey, Female sex to alcohol use, drui\ken clients entertamed and its \vorkers (FSWs) and their clients, Mmistr\- of association with cormisteiit condom use In spite of health ai\d family welfare go\-emment of India limitations, the study has underlined alcohol use in 200to FSWs and clients pose a big hurdle m achie\’ing the Medhi GK,Mahanta J, Pl\ukan S.Goswami P, goal of safe sex in this high nsk group Tlie study Paranjape R Risk factors of sexually transmitted fmdmgs re\'eal the necessity- of implementation of infections (STI) and theirrelationship with HI\' mten-ention strategies which would keep FSWs a\vay among female sex ivorkers (FSW) m Nagaland, a from habit of alcohol use, and prohibit them from high HIV' prevalence state in India , 7“' IAS entertaining drunken chents conferei\ce on H I\' pathogenesis, treatment and pre\-ention - SO** Jxme 3 July 2013 Behavioral interventions like counseling and Rajaram S, Roy A, Gurav K, Ramesh BM, creating a^vareness to reduce alcohol use among FSWs Jaychandran A,Lowndes C, Alar\" M, Moses S, demonstrated reduced drinking levels in FSWs in Bradley J Programme exposure and sexual M ianu and Flonda respecti\’ely <'*■**'. Implementation beha\ior in female sex ^'/orkers, Bellar\' distnct of umo\'ati%'e strategies m mter\-ention prorammes Kan\ataka state, CHARME Worku\g Paper No \s^uld help control alcohol addiction m FSWs / 12 Ma>’ 2010 Conflict ot Inteiest: The author declares that she does 9 Knttika S, Sex ivorkers abxise alcohol to cope with not have competmg interest stigma of their job, Jan 2010 10 Sivoram S, Johnsoi\ S, B entley M E Exyhriiig “witic REFERENCES shops" as a ('eniic for HIV prrirnhon intcrwitioiis in urlmi Indm J Urban Health 2007,S4 563-76 1 Li Qmg, Li Xiaoming, Stanton B Alcohol Use 11 V'erma R K, Saggurti N, Singh A K, Swain S N Among Female Sex Workers and Male Clients: Alcohol and sexual nsk behavior among migrant An Integrative Review of Global Literature, female sex ^vorkers and male workers in districts Alcohol and Alcoholism 2009, Dec2‘) V o lu m e 45 with high in-migration from four high Issu e 2 P p ISS-IW HrV'prevalence states in India AIDS Behav 2010 2 Samet JH, Pace CA, Cheng DM, ColemanS, Aug:14Suppl 1 S31-9 doi 10 1007/sl04bl-010- BnddenC, Pradeshi M, Saggurti N, Raj A Alcohol 9731->- Use and Sex Risk Beha\iors Among HlV'-Infected 12 Tl\e World Bank Washington B C The Global Female Sex W orkers (FSWs) and HlV'-Infected HIV Epidemics among Sex Workers, Male Clients of FSWs in India,2010,Aug, AIDS »v%v%v\vorldbank.oig and Beha\ior August 2010, Volume 14, Issue 1 13 Gei\ests & Growth http / /im l jcru ufl edu/ Supplen\ei\t, pp 74-83 (Ref 23) 14 Nyambura M Alcohol use and High risk sexual 3 Luchters, W Bosire, N Kingola, M Tenunerman, behavior among female sex workers m Nairobi, M P Chersich Hazardous and harmful alcohol use Kenya, Board of post graduate studies, http : aniong female sex ^vorkers m Kenya, associations bps uonbi ac kc with risk\’ sexual behavior and H I\' mcidence: a 15 Odukoya OO, Sekoni AO, Onajole co h o rt s tu d y S Glohalr^tioii aitd HcaUh 2014, AT, Upadhyay RP Alcohol consumption and 4 Alem A,Kebede D, Mitike G, Lemma W cigarette smokmg pattern among brotliel-based Unprotected sex, sexually transmitted infections fen\ale sex ^^rorkers in t\vo local gm em n^ent areas and problem drinking among female sex \vorkers in Lagos state, Nigeria AfrHealth Sci 2013 in Ethiopia Ethiopian Journal of Health Jun, 13(2) 490-7 doi 10 4314 /ahs vl3i2 41 D e\-elopm ent (200t>) V'ol 20, N o 2 > (5) It) Hera\'ian A, Solonion R, Knshnan G, Vasudevan 5 Zhang X D.Temmerman M, Li Y, Luo W, C K, Knshnan A K, Osmand T, Ekstrand M L Luchters L Vulnerabilities, health needs and Alcohol consumption patterns and sexual risk predictors of high-nsk sexual behavior among behaMor among female sex workers m hvo South female adolescent sex vvorkers in Kunming, Indian communities Int J Drug Polic\- 2012 Nov; C hina SfxTransm IiifcctHoi 10 1136/5cxtran$-2012- 23(b) 493-504 doi 10 lOlb/j drugpo 2012 03 005 0506 Epub 2012 Ma\- IS Indian Journal of Public Health Research & Development Institute of Medico-Legal Publications 4th Floor, Statesman House Building, Barakhamba Road, Connaught Place, New Delhi - 110 001 Tel.: +91 - 9971888542 Email : editoMjphrd@gmail,com Website : www ijphrd com ' ♦fw----- DU''' No 5080/IJPHRD/2015 05-05-2015 To, Manisha Gore, Ph.D student. Department of Anthropology, University of Pune, Pune Dear author/s 1 have pleasure to inform you that your following paper has been accepted for publication in Indian Journal of Public Health Research & Development Presence of organizational barriers ; impedes condom use practices - Experiences o f brothel based female sex workers - A study conducted in the red light area o f Pune city Manisha. N. Gore', Sanjay K Juvekar''^ 1. Ph.D student. Department of Anthropology, Savitribai Phide Pune University, Ganeshkhind Pune-4} 1007 I, 2. Ph.D Guide, Department of Anthropology, Savitribai Phule Pune University. KEM Hospital Research Centre Pune It will be published in due course of time. It is further mentioned for your information that our journal is a double blind peer reviewed indexed international journal. It is covered by Index Copernicus (Poland), Indian Citation index, Google Scholar, CINAHIL, EBSCOhost (USA), EMBASE (Scopus) and many other international databases. The journal is now part of CSIR, DST and UGC consortia. With regards Yours sincerely Prof R K Sharma Editor