This comprehensive HIV preventive intervention empowering FSW has resulted in striking increases in reported condom use and a concomitant reduction in the prevalence of curable STI. This model should be replicated in similar urban settings across India.

Growing public health attention has been placed on the HIV vulnerability of males who sell sex to males in India. However, there is little research that outlines the trajectories through which males come to be involved in practicing sex work in India. Locating "male sex work" within a vibrant social, political, and erotic landscape, this article explores the intertwining of "sexual subjectivity" and "sex work." The authors refer to 70 sexual life histories generated from research conducted in Mysore to unsettle dominant public health notions that regard male sex work as rooted solely in poverty or as a decontexualized "behavioral risk factor." Such perspectives are countered by demonstrating how male sex work in Mysore encompasses a complex interplay between self-realization, sexual desire, social interaction, and public health discourse. Local conceptualizations of selfhood are discussed to suggest the limitations of prevailing empowerment discourses that advance Western notions of individuality.

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To inform PrEP roll out, Ashodaya Samithi, a sex workers' collective, conducted a community-led prospective demonstration project among female sex workers in Mysore and Mandya, India. Following a community preparedness phase and pre-screening, participants were recruited for clinical screening and enrolment, provided PrEP as part of combination HIV prevention, and followed for 16 months. Adherence was measured by self-reported pill intake and by tenofovir blood level testing among a subset of participants. Of the 647 participants enrolled, 640 completed follow-up. Condom use remained stable and no HIV seroconversions occurred. Self-reported daily PrEP intake over the last month was 97.97% at the end of the study. Tenofovir blood levels >40 ng/mL (consistent with steady state dosing) were detected among 80% (n = 68/85) and 90.48% (n = 76/84) of participants at month 3 and 6, respectively. Our study holds important insights for rolling out PrEP in community settings as part of targeted HIV prevention interventions.