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