HIV Prevention Amongst Commercial Sex Workers in Haiti

This 25-page report from Haiti uses narrative-based qualitative research obtained through the "PEER (Participatory Ethnographic Evaluation and Research)" process to gather data from commercial sex workers (CSWs). It uses "FoQus on Concept Development for output of segmentation analysis to direct the qualitative research", so that "marketers will be better able to hear the voice of target groups, and respond with brands, campaigns, and messages that are consistently effective at influencing health related behaviors." This six step process is detailed in the document as:

1. "Identify beliefs to reinforce and beliefs to change;
2. Build a character archetype;
3. Create a personality for a brand, campaign, or message;
4. State the promise of that brand, campaign, or message for the consumer;
5. Position that promise relative to competing behaviors or brands; and
6. Develop a marketing mix.

Together, these six components form a ‘concept’ within a marketing plan. That concept links segmentation, consumers, and brand strategy to the marketing mix."


Twenty-two CSWs in Port au Prince, Haiti, worked as peer researchers and analysts. The data analysis took place among the peer researchers through a facilitated workshop session at the end of the data collection period. The social scientist also conducted a detailed analysis using standard techniques for qualitative textual analysis.


The document describes the archetypal identities of several sex workers depending on their type of place of employment (called Kafes and Mackerels). It includes in each discussion of findings an analysis of the availability of condoms, the attitudes toward condom use, the perception of risk of HIV/AIDS, and the self efficacy to negotiate condom use, particularly for non-client partners ("partners of the heart"). It suggests beliefs to reinforce among CSWs and beliefs in need of change through marketing messages.


Findings include:

• an analysis of where sex is sold;
• the socio-economic context of Hatian CSWs, including their other income-generating activities and their aspirations to develop other businesses such as petty trading or to attract a wealthy husband to enable them to leave the sex trade;
• use of condoms as a practice essential to their trade, including observations on the lack of self efficacy in protecting themselves with clients who use drugs and alcohol or are violent;
• the perception that more 'trusted' relationships with men require less condom use;
• the necessity of designing interventions that do not arouse jealousy or conflict among the CSWs; and
• improvements in qualities of condoms and predictability of supplies and prices.

The document concludes with its intervention strategy results:
"A strategy workshop was held ... using the PSI FoQus on Concept Development process. Self efficacy, risk perception with trusted partners, and attitudes toward condoms were identified as the behavioral determinants for intervention. The process identified key beliefs to change, and others to reinforce in influence these determinants, using attitudes expressed by the CSWs themselves in their interviews. The FoQus on concept development process also identified that a successful intervention would need to be perceived as, amongst other attributes, “Young, clever, street smart, entrepreneurial, ambitious, competent, professional and self-reliant” to be relevant to this group. It would be focused around a promise that “The products, skills, and knowledge under [the brand name] Condomania will help you take control today, to secure your future.” Positioned as “more effective at securing their and their children's future than going it alone.” An appropriate marketing strategy to deliver this promise was also developed, primarily focused on improved condom distribution to this group, coupled with scaled up peer based interpersonal communication (IPC) work within [places of CSW employment] Kafes and Mackerels."