Partner notification (PN) in a targeted STI control program – best practices of Sonagachi project, Kolkata, India

S. Jana, D. Chowdhury, A. Singh, P.L. Chan, S. Mukhopadhyay, R. Steen

Issues: PN is an important component of STI/HIV interventions in sex work settings. Systemic implementation of PN can enhance control of STIs in high transmission networks where partner turnover is high. The Sonagachi Project, Kolkata, India is a recognized model STI/HIV intervention reaching more than 7000 sex workers. It has successfully established core public health interventions within a community empowerment model where sex workers are mobilized to handle their problems and participate actively in STI/HIV programs.

Description: Four categories of sexual partners of FSWs have been identified in Sonagachi - regular clients, flying (once-off) clients, Babus (cohabiting partners) & spouses.

PN was facilitated by the following approaches:

1) Introduction of ‘Babus’ as male peers for mobilizing visiting clients for STI screening and promoting safe sex,

2) Establishment of evening clinic hours exclusively for clients,

3) Coordination with health clinics outside brothels for notification of spouses of both sex workers and clients

4) Regular sensitization of local private practitioners for treating partners with index cases following National guidelines

5) Tracking regular and flying clients by highly motivated and trained peers from sex worker community

6) Motivational counseling for sex workers visiting STI clinics for concurrent PN

7) Mobilizing members of the sex workers’ community in management of the STI clinics and monitoring of the STI services (the basis of the empowerment approach).

Lessons learned: The community empowerment model implemented in Sonagachi since 1992 has demonstrated multiple success in HIV prevention. Consistent condom use is up to 85% and HIV prevalence among sex workers has remained stable below 10%. Sonagachi has also established innovative methods of PN with high rates of partner treatment, up from 40% in 2002 to 46% in 2007 (13 STI clinics).

Next steps: Sonagachi’s experience of implementing PN is being adapted for use in other sex work settings across India.

Selected for poster presentation in AIDS 2008 - XVII International AIDS Conference

(Abstract no. THPE0303)