Bridging Disciplinary Boundaries (January 11 - 14, 2007)

In contrast to the high HIV prevalence among sex workers in Indian cities like Bombay, Delhi and Chennai (ranging from 50 to 90%) seroprevalance in Calcutta appears to be about 11%. The percentage of sex workers in Calcutta reporting use of condoms rose from 3% in 1992 to 90% in 1999. The significantly low rate of HIV infection and high rate of condom use among sex workers in Calcutta has been attributed to the Sonagachi Project Intervention (SPI) which utilizes sex workers engaging in HIV education, formation of community-based organizations and advocacy around sex work issues. While the Community-led Structural Intervention (CLSI) aspects of SPI, and its effects on behavior have been described in previous research, the mechanism by which it brings about individual-level change in risk behavior has not been studied. This research examines how SPI has helped in the formation of collective identity, which has reduced risk among sex workers. In-depth qualitative interviews were conducted among 50 female sex workers involved in SPI in 2005. Interviews were conducted in Bengali and Hindi, the subjects' native languages. Subjects were recruited using convenience sampling methods through the membership list of Durbar Mahila Samanwaya Committee (DMSC), the sex workers' collective that implements the intervention among its peers. Interviewing DMSC members ensured inclusion of subjects who had been exposed to SPI and had subsequently reduced their own risk behavior. Results were interpreted using the collective identity mobilization model of Social Movement Theory. We found that sex workers exposed to SPI change their high-risk behavior by engaging in a three-stage process of collective identity construction that entails: 1) building boundaries with out-group members, 2) establishing consciousness around sex work as employment and 3) negotiating consciousness with out-group members through the use of condoms, engagement in HIV education and sex-work related advocacy. This paper argues that the behavior change comprising the last stage of the process is preceded by the oppositional identity-establishment and the meaning-making that comprise the first two stages. The results have implications for designing successful CLSIs and replicating the Sonagachi model in other sex work communities. Future interventions will benefit by gauging the pre-intervention levels of boundaries, consciousness and negotiation engaged in by a targeted community in order to identify processes that need to be buttressed. Interventions will also be able to measure progress by tracking levels of engagement in each of the three stages. Finally, the components of collective identity formation among sex workers identified in this research can form the basis for the construction of a culturally relevant instrument to measure community empowerment.