Key Components in Planning, Implementing and Monitoring a Behavior Change Communication Campaign that Increased Condom Use Among Male Clients of Sex Workers in Southern India
Abstract

India is home to nearly 10% of all people living with HIV worldwide or approximately 2.5 million people. The primary mode of HIV transmission in India is heterosexual commercial sex. In conjunction with the Avahan India AIDS Initiative, funded by the Bill and Melinda Gates Foundation, Population Services International (PSI) developed and implemented an intervention to reduce HIV incidence, in part by increasing consistent condom use among heterosexual male commercial sex clients in southern India. The project focused on 100 "high priority" towns in the provinces of Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. The intervention targeted heterosexual male commercial sex clients of low socio-economic status in the high priority towns. Communication activities focused on interpersonal methods, such as street plays, contests, and group discussions. The project was largely successful in meeting its objective. Clients of commercial sex workers increased their reported consistent condom use during commercial sex from a baseline of 63% in May 2006 to 81% in May 2007 following the intervention. This 18% increase is strongly correlated with exposure to PSI's communication activities (p<0.01), and indicates a high level of achievement as compared to other voluntary behavior change communications campaigns.