Exceeding the Individual: a Qualitative Examination of a Community-Led Structural Intervention and Its Implications for Sex Workers and Their Families

Abstract

Introduction: While scholarship on community-led structural interventions has focused on contextual modifiers of HIV risk, few studies have examined other aspects of sex workers’ lives. The effects of community-led structural interventions are often isolated to individuals’ behaviors, such as condom use and number of sexual partners. However, comprehensive approaches toward modifying individuals behavior can also influence aspects of their family life. Evaluating such far-reaching effects is essential to better understand the success and sustainability of intervention efforts. In this study, we explore the impact of a sex workers’ community-led structural intervention, Durbar Mahila Samanwaya Committee (Durbar), on sex workers and their children. Initiated in 1992, Durbar has been hailed by the World Health Organization as a model community-led structural intervention for sex workers around the world. Methods: In partnership with Durbar, we conducted in-depth, semi-structured qualitative interviews with 35 sex worker mothers. In addition, we engaged in participant observation and documented processes through extensive field notes. Results: This study found that the Durbar collective has made various resources available both in the material and symbolic realms that improved the quality of life of sex worker mothers and their children. Conclusion: It is important to evaluate primary intervention outcomes along with other meaningful outcomes that have the potential to secure community buy in and sustain effects over time.