Developing and implementing sex work projects
HIV service provision for sex workers must be comprehensive and responsive to the diversity of health and social care needs. Services must be accessible to female, transgender and male indoor and street-based sex workers, including those who are HIV-positive. Accessible harm reduction services are needed for drug users.
Clinical services are an important part of comprehensive programming for sex workers. STI diagnosis treatment and prevention, HIV testing, family planning, maternal and child health, safe abortion and diagnosis and treatment of STIs and Reproductive Tract Infections (RTIs) are important components of comprehensive sexual and reproductive health services.
Recently, the 2011 HPTN 052 study by the HIV Prevention Trials Network, has shown unequivocally that initiation of anti-retroviral treatment (ART) by people with HIV substantially protects their HIV-uninfected sexual partners from acquiring infection, with a 96% reduction in risk of HIV transmission. Clinics should provide treatment to all sex workers that need it and information to encourage safe sex practices. Correct use of condoms for penetrative sex is a cornerstone of effective HIV prevention. It is crucial to ensure the availability of affordable quality condoms with easily understood information about safer sex.
Structural interventions, community mobilisation and empowerment - which support sex worker associations to advocate for policy and legislative change - are also now proven to be important components of the response to HIV. Risk is lowest where sex workers are able to assert control over their working environments and highest where sex workers are most powerless and unable to demand safe practices.
Clinical services are an important part of comprehensive programming for sex workers. STI diagnosis treatment and prevention, HIV testing, family planning, maternal and child health, safe abortion and diagnosis and treatment of STIs and Reproductive Tract Infections (RTIs) are important components of comprehensive sexual and reproductive health services.
Recently, the 2011 HPTN 052 study by the HIV Prevention Trials Network, has shown unequivocally that initiation of anti-retroviral treatment (ART) by people with HIV substantially protects their HIV-uninfected sexual partners from acquiring infection, with a 96% reduction in risk of HIV transmission. Clinics should provide treatment to all sex workers that need it and information to encourage safe sex practices. Correct use of condoms for penetrative sex is a cornerstone of effective HIV prevention. It is crucial to ensure the availability of affordable quality condoms with easily understood information about safer sex.
Structural interventions, community mobilisation and empowerment - which support sex worker associations to advocate for policy and legislative change - are also now proven to be important components of the response to HIV. Risk is lowest where sex workers are able to assert control over their working environments and highest where sex workers are most powerless and unable to demand safe practices.
Recommended reading
- Making sex work safe
- C. Overs;A. Hunter / Global Network of Sex Work Projects, 2010
- ‘Making Sex Work Safe’ is a handbook, originally written by Cheryl Overs and Paulo Longo in 1996, which presents some of the knowledge and experience gained by projects involved in respond...
- Treatment as prevention: how might the game change for sex workers?
- C. Overs / Paulo Longo Research Initiative, 2011
- This article looks at the potential impact of partially effective, non-contraceptive HIV prevention methods on sex workers in the light of recent news that anti-retroviral treatment (ART) by people wi...
- ‘Our lives matter: sex workers unite for health and rights’
- A.L. Crago / Open Society Institute and Soros Foundations Network, 2008
- This report highlights the creative ways in which sex workers in eight countries have organised to defend their human rights and health. The groups featured in this report include: ...
- Sex work
- International Planned Parenthood Federation , 2008
- This short update from IPPF contains an article by Melissa Ditmore, the former coordinator of the International Network of Sex Work Projects. She outlines some key principles of HIV programming with s...
- Working from a rights-based approach to health service delivery to sex workers
- N. Van Beelen;M. Ditmore / Exchange on HIV/AIDS, Sexuality and Gender, 2007
- This article, in Exchange on HIV/AIDS, Sexuality and Gender, focuses on the relationship between HIV and sex workers’ rights. ...
- Understanding power and creating spaces: sex workers’ voices in HIV prevention
- CARE International, 2004
- This paper, from the SAKSHAM project of CARE India, explores different dimensions of power in the sex work industry and considers these issues in relation to HIV prevention with sex workers. The auth...
- Sex work, violence and HIV: a guide for programmes with sex workers
- M. Greenall / International HIV/AIDS Alliance, 2008
- To be effective, HIV/AIDS prevention and care programmes must address the broader factors that make people vulnerable to HIV/AIDS. Human rights abuses, stigma, discrimination and marginalisation st...
- SANGRAM’s collectives: engaging communities in India to demand their rights
- US Agency for International Development , 2011
- This AIDSTAR One case study series describes the work of SANGRAM, an NGO and a series of collective empowerment groups for stigmatised communities (sex workers, men who have sex with men, and transgen...
