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Queen's University

Department of Global Development Studies


HIV Prevention Through Empowerment: An Assessment of The Shifting Trends in Anti-HIV Frameworks and Program Priorities of Health Interventions in Indian Female Sex Worker (FSW) Communities From 1992 Onwards

By: Ali Tejpar

Abstract: As a population segment highly vulnerable to HIV infection, Indian female sex workers (FSWs)
represent a demographic that has been targeted through numerous health interventions. As such, four
various development endeavours and the shifting trends in their HIV-prevention frameworks are assessed
chronologically. The Sonagachi Project of 1992 framed HIV prevention in terms of worker and women’s
rights. This endeavour sought to empower FSWs through peer education to increase HIV awareness and
establish social support networks. The National AIDS Control Programme of the same year was
contrastingly focused on providing access to social and health resources such as condom promotion and
antiretroviral therapy. However, research conducted in FSW communities have emphasized that condom
promotion efforts have limited success given the structural inabilities of FSWs to negotiate condom use
with male stakeholders. The third intervention, the Aastha project of 2004 – implemented by Family
Health International, thereby focused on facilitating collective mobilization against oppressive
stakeholders for over 20,000 FSWs throughout the targeted region. The final project, the Avahan initiative
of 2010 – funded by the Gates Foundation, accordingly sought to address the need to empower FSWs
through improving their advocacy and negotiation skills with clients, while also enhancing their access to
social and health resources. Through an assessment of the shifting priorities of anti-HIV efforts in FSW
communities, it has become increasingly evident that recent endeavours to incorporate access to health
and social resources in addition to collective and individual empowerment strategies have provided
effective and sustainable solutions in reducing HIV risks. Challenges however remain in achieving
comprehensive HIV interventions through including male stakeholders in project planning and

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