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BACKGROUND Avahan, the India AIDS Initiative, is a large-scale targeted intervention. Data on condom use prior to Avahan are unavailable. The authors used a novel method of analysing cross-sectional survey data to 'reconstruct' condom use rates in presurvey years, and to assess the relationship between Avahan and time trends in condom use among female sex(More)
OBJECTIVE This paper presents key methodological approaches and challenges in implementing and analysing the first round of the integrated biobehavioural assessment of most-at-risk populations, conducted in conjunction with evaluation of Avahan, the India AIDS initiative. METHODS The survey collected data on HIV risk behaviours, sexually transmitted(More)
BACKGROUND Empowering sex workers to mobilise and influence the structural context that obstructs risk reduction efforts is now seen an essential component of successful HIV prevention programmes. However, success depends on local programme environments and history. METHODS The authors analysed data from the Integrated Behavioural and Biological(More)
BACKGROUND The HIV epidemic is very heterogeneous at the district level in the four Southern states of India most affected by the epidemic and where transmission is mainly heterosexual. The authors carried out an ecological study of the relationship between high-risk population parameters and HIV prevalence among pregnant women (ANC HIV prevalence). (More)
BACKGROUND Avahan, the India AIDS initiative of the Bill & Melinda Gates Foundation, was a large-scale, targeted HIV prevention intervention. We aimed to assess its overall effectiveness by estimating the number and proportion of HIV infections averted across Avahan districts, following the causal pathway of the intervention. METHODS We created a(More)
OBJECTIVE This paper evaluates Avahan programme's coverage of female sex workers (FSWs), focus on high-risk FSWs and intermediate outcomes. METHODS First round of cross-sectional survey data, Integrated Behavioral and Biological Assessments (IBBA), conducted in 22 districts, were aggregated into district categories: Solo, where Avahan was the sole service(More)
OBJECTIVES To describe formal, external to programme methods for size estimation of high-risk populations and compare execution challenges and validity of results. DESIGN A cross-sectional HIV risk behavioural and biological survey was implemented among 24, 10 and five female sex workers, high-risk men who have sex with men and injecting drug user survey(More)
INTRODUCTION Role of vaginal sex in heterosexual transmission of HIV has been investigated but that of heterosexual anal sex (HAS) is not fully understood. This paper examines practice of HAS among Female Sex Workers (FSWs) and its correlates in India where the HIV epidemic is being primarily driven by core groups like FSWs. METHODS Data for this paper(More)
OBJECTIVES Self-reported anal intercourse by female sex workers (FSWs) documented in recent studies from India range between 11.9% and 22%. However, comparable data on anal intercourse and condom use from male clients of FSWs is lacking. Using data from a bio-behavioural survey (2009-2010), we examined prevalence of anal intercourse, male clients'(More)
BACKGROUND As one way of assessing the impact of Avahan, the India AIDS Initiative of the Bill & Melinda Gates Foundation, we examined the association between HIV prevention program indicators and changes in HIV prevalence among female sex workers (FSWs) between 2005 and 2009. METHODS We conducted a secondary data analysis from 2 large cross-sectional(More)