Knowledge and exercise of human rights, and barriers and facilitators to claiming rights: a cross-sectional study of female sex workers and high-risk men who have sex with men in Andhra Pradesh, India

Abstract

BackgroundHIV prevention interventions recognize the need to protect the rights of key populations and support them to claim their rights as a vulnerability reduction strategy. This study explores knowledge of human rights, and barriers and facilitators to claiming rights, among female sex workers (FSWs) and high-risk men who have sex with men (HR-MSM) who are beneficiaries of a community mobilization intervention in Andhra Pradesh, India.MethodsData are drawn from a cross-sectional survey (2014) among 2400 FSWs and 1200 HR-MSM. Human rights awareness was assessed by asking respondents if they had heard of human rights (yes/no); those reporting awareness of rights were asked to spontaneously name specific rights from the following five pre-defined categories: right to health; dignity/equality; education; property; and freedom from discrimination. Respondents were classified into two groups: more knowledgeable (could identify two or more rights) and less knowledgeable (could identify one or no right). Univariate and bivariate analyses and chi-square tests were used. Data were analyzed using STATA 11.2.ResultsOverall 17% FSWs and 8% HR-MSM were not aware of their rights. Among those aware, 62% and 31% respectively were aware of just one or no right (less knowledgeable); only around half (54% vs 57%) were aware of health rights, and fewer (20% vs 16%) aware of their right to freedom from discrimination. Notably, 27% and 17% respectively had not exercised their rights. Barriers to claiming rights among FSWs and HR-MSM were neighbors (35% vs 37%), lack of knowledge (15% vs 14%), stigma (13% vs 22%) and spouse (19% FSWs). Community organizations (COs) were by far the leading facilitator in claiming rights (57% vs 72%).ConclusionsThe study findings show that awareness of human rights is limited among FSWs and HR-MSM, and a large proportion have not claimed their rights, elevating their HIV vulnerability. For a sustained HIV response, community mobilization efforts must focus on building key populations’ awareness of rights, and addressing the multiple barriers to claiming rights, with a view to creating a safe environment where vulnerable groups can demand and use services without fear of stigma, discrimination and violation of rights.

Traumatic Associations amongst Men and Women Selling Sex in the Philippines

“…Furthermore, compared to participants with no prior experience, those who had participated in community mobilization activities before this study were much more likely to be interested in future organization participation. These findings support the literature on community mobilization, which has intervened against several health and human-rightsrelated issues such as violence against women and the HIV epidemic [28,[45][46][47][48]. HIV prevention interventions involving community mobilization have effectively improved collectivization outcomes for persons trading sex in other global contexts.…”

Stigma, violence and HIV vulnerability among transgender persons in sex work in Maharashtra, India

“…At the individual level, transgender persons must be made aware of their rights, linked to community-based legal services, and supported to access social entitlements, financial inclusion schemes and employment opportunities other than sex work (Ganju et al 2016 ). Interventions must provide transgender sex workers with HIV prevention information, including the need for consistent condom use in all partnerships.…”

Inconsistent condom use for prevention of HIV/STIs among street-based transgender sex workers in Lahore, Pakistan: socio-ecological analysis based on a qualitative study

“…increasing availability of variety of condoms and lubricants at cruising spots and in the community, addressing the influence of economics on a KSW’s capacity to negotiate condom use, adopting a sex positive approach in HIV intervention programs and healthcare settings and addressing violence from street level bureaucrats. In addition, awareness of human rights of KSWs, creations of linkages of KSWs to community-based legal services, social entitlements and job opportunities are needed to uplift their social status in Pakistan [ 51 ].…”