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Is Mental Depression a Serious Issue among Female Sex Workers? Evidence from Southern India

Is Mental Depression a Serious Issue among Female Sex Workers? Evidence from Southern India. Sangram Kishor Patel 1 , Niranjan Saggurti 1 , Saroj Pachauri 1 , Parimi Prabhakar 2 1 HIV and AIDS Program, Population Council, New Delhi, India; 2 India HIV/AIDS Alliance, Hyderabad, India

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Is Mental Depression a Serious Issue among Female Sex Workers? Evidence from Southern India

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  1. Is Mental Depression a Serious Issue among Female Sex Workers? Evidence from Southern India Sangram Kishor Patel1, Niranjan Saggurti1, Saroj Pachauri1, Parimi Prabhakar2 1HIV and AIDS Program, Population Council, New Delhi, India; 2India HIV/AIDS Alliance, Hyderabad, India Session: THAB01; Track B: Time: 16:30-18:00 PM; 24th July, 2014 20th International AIDS Society Conference, Melbourne, Australia

  2. Context of sex workers in India • Poverty/Financial debt • Trafficked into sex work • Mobility/Migration • Violence • HIV risk • Social exclusion • Working and living environment • Lack of supporting policies

  3. Rationale of the study • Mental health-related disorders contribute to nearly 13% of the total global disease burden (MHA, 2011) • Life time prevalence of mental health disorders in India: 10-12% (NIMH, 2012) • With HIV epidemiological transition, new challenges are emerging: e.g. NCD (including depression) • Mental health among female sex workers is a largely neglected issue in India

  4. Objectives • Understand the prevalence of major mental depression among female sex workers in southern India. • Examine the factors associated with major depression among female sex workers.

  5. Data and methods • Cross-sectional Behavioural Tracking Survey (2010) (N=1986 female sex workers) in selected districts of Andhra Pradesh • Depression accessed using Patient Health Questionnaire-2 (PHQ-2) (<3: No/low depression; ≥3: Major depression) (Kroenke, Spitzer and Williams, 2003) • Descriptive statistics, Frequency, Bivariate analysis and Multiple logistic regression analysis conducted using Stata 11.2

  6. Results

  7. Background characteristics • Age: Mean = 29.2 years (SD=5.3 years) • Marital status: • 57% currently married • 34% widowed/deserted/divorced/separated • 9% never married • Typology of sex work: • 64% public places/street-based • 28% home based • 8% brothel- and lodge-based • 44% had no formal education and most (85%) were currently under financial debt • >11% had faced physical violence in 6 months prior to the survey

  8. PHQ-2 and mental health status as reported by sex workers in southern India, 2010

  9. Who are more likely to report major depression? Sex workers: • living with non-family members • under financial debt • mobile for sex work • arrested by police • who do not want to report their HIV status Note: CI: Confidence Interval; AOR: Adjusted Odds Ratio; AOR are adjusted for age, education, marital status, typology, usual place of practicing sex work and reasons for entry into sex work

  10. Summary and Recommendations • A significant proportion (two-fifths) of female sex workers have reported major mental depression. • Sex workers’ financial vulnerability and sex work contexts are significantly associated with poor mental health. • Financial security and creating enabling environment at local level should be prioritized to improve mental health of this marginalized group. • HIV prevention interventions could expand to implement mental health counselling as part of the programme to build self-efficacy in the short-term, and to achieve healthy communities in the long-term.

  11. For more information:SangramKishor Patel, PhDHIV and AIDS Program, Population Council New Delhi, INDIAEmail: skpatel@popcouncil.orghttp://www.popcouncil.orgThank You… Acknowledgements Avahan, the India AIDS initiative of the Bill & Melinda Gates Foundation

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