Cheryl Overs

Senior Programme Officer, Focused Prevention

International HIV/AIDS Alliance

Innovative Approaches to HIV Innovative Approaches to HIV Prevention in Commercial SexPrevention in Commercial Sex

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Role of Commercial Sex in HIV Role of Commercial Sex in HIV EpidemicsEpidemics

• the right policy and programming can reduce HIV transmission during commercial sex dramatically

• prevention in commercial sex averts more secondary cases

leading to

• a significant impact on the broader dynamics of the epidemic

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Sex Workers: Sex Workers: from Grim Reaper to Agent of Changefrom Grim Reaper to Agent of Change

• 1980s: risk groups

• 1990s: a backlash

• 2000+: new focus

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A new paradigm A new paradigm

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Three StrategiesThree Strategies

• individual /

cognitive

• participation / empowerment

• enabling

environment

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Participation and EmpowermentParticipation and Empowerment

Social Capital: the ability to secure benefits through membership in networks and other social structures

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Social InclusionSocial Inclusion

• maintaining contact with families• access to resources

- (primary) health care- documentation- housing- children’s schooling

- financial management• self-esteem• civil rights• culture

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Creating an Enabling Creating an Enabling EnvironmentEnvironment

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Opportunities for Solidarity Opportunities for Solidarity

• wherever working conditions have been improved solidarity among workers has been a factor.

• mutual support and efficient use of limited resources

• advocacy and political action- many voices are stronger than one

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Solidarity in action Solidarity in action

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Successful Policy and Successful Policy and ProgrammingProgramming

Many interventions produce ……….

*increased condom use *reduced STIs

Some have produced ……..• increased literacy • increased safe sex practices• decreased dependence on sex

work• increased financial autonomy

among sex workers• reduced child & forced prostitution• reduced injecting/needle sharing • reduced HIV transmission

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Controversial Policy and Controversial Policy and ProgrammingProgramming

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Some ChallengesSome Challenges

• mobile and migrant sex workers. • drug users • male and transgender sex workers• refreshing the messages • informal sex work• income generation and exiting strategies• linking prevention and care• safe sex skills

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Care Today IS Prevention Care Today IS Prevention Tomorrow Tomorrow

• care settings are an opportunity to provide

access to condoms and other resources information on rights, services and support

• reduced viral load and improved general health leads to reduced transmission

BUT

by threatening access to care, stigma and discrimination undermine prevention.

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Repackaging Safety and PleasureRepackaging Safety and Pleasure

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Tel:    +44 1273 718 900Fax: +44 1273 718 901www.aidsalliance.org www.aidsmap.com