Sex Work and HIV/AIDS

Excerpt from "At a Glance"

This update focuses on the challenges in the protection of those involved in sex work and discusses the key elements of various interventions. Successful HIV/AIDS prevention and care programmes for those involved in sex work use a mix of strategies. The effective key strategies that have been identified to date are:

• promotion of safer sexual behaviour among sex workers, clients and institutions or groups associated with sex workers, such as police and sex workers' partners:
  • condom availability and correct use
  • negotiation skills
  • supportive policies
• promotion and availability of STI prevention and care services
• outreach work that includes health, social and legal services
• peer education among sex workers, clients and associated groups
• care of people living with HIV/AIDS (PLWHA)
• advocacy for policy and law reform at national and local levels, including respect of human rights.

Current HIV/AIDS prevention programmes involving sex work are sometimes limited in terms of coverage, inclusion and coordination of stakeholders, and long-term effectiveness and sustainability. When developing,implementing, monitoring and evaluating programmes, it is important to consider the following:

• the active involvement of sex workers themselves in all phases of project development, implementation and evaluation;
• within AIDS-related programmes, at least, the establishment of ethical and protective policies since sex workers become increasingly visible through their involvement in HIV prevention activities;
• incorporating a situation analysis and mapping exercise fordesign and subsequent monitoring and evaluation (this exercise should include people and authorities affiliated with the sex trade, e.g. third parties);
• coordination of responses and resources; this should include useof a national planning exercise and prioritization of interventions;
• identification and inclusion of a range of project partners, including sex workers, communities, private enterprises and sectors other than health; and
• taking a longer term and broader perspective on ways todecrease vulnerability of sex workers by addressing the conditions (including economic and gender issues) surrounding sex work.