Calling India's Sex Workers

Thanks to an innovative new outreach, sex workers in Bangalore are receiving important health reminders via automated cell phone messages.

Many Bangalore sex workers are migrants from rural India and are easy prey to men who will pay more for condomless sex. The advocacy group Project Pragati ("progress") was formed in 2005 by sex workers and for sex workers, after a study found that 12.5 percent of them were HIV-positive. In addition to advice on matters such as health issues and violence prevention, the project assists women by making small loans.

Three individuals -- Nithya Sambasivan of the University of California-Irvine, and Julie Sage Weber and Edward Cutrell of Microsoft Research India -- came up with a way for Project Pragati to reach sex workers with reminders to get tested for STDs, take their medicine, and make their scheduled loan payments. Recognizing that 97 percent of Bangalore sex workers have cell phones, they used the open-source telephony software Asterisk to contact them via recorded messages.

The calls are placed between 4 and 7 p.m., hours when both day and nighttime sex workers are likely to have their phones switched on. Because many of the women hide their sex work from their families, discretion is key: The messages reference blood tests and health exams, avoiding any mention of HIV or STDs, in case a relative picks up the phone. The use of voice, instead of text, messages in the local languages bypasses concerns about low literacy.

Research shows a high level of participation. The 31-second health care calls were picked up by 90 percent of the women, with almost 60 percent listening to the full message. Ninety-five percent picked up the 13-second finance message, and 90 percent listened to all of it.

A report on the success of the outreach is due to be presented in May at the Computer-Human Interaction Conference on Human Factors in Computing Systems in Vancouver, Canada, in May.

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