20th International AIDS Conference - Melbourne, Australia

MOAD02 Living, Loving, Working: HIV and Sex Work
  Oral Abstract Session : Track D
Venue: Plenary 3
Time: 21.07.2014, 14:30 - 16:00
Co-Chairs: Jules Kim, Australia
Stefan Baral, United States

Prevention of HIV among bonded sex workers through establishing human rights
J.S. Piwoo, A.Y. Choudhury
PIACT Bangladesh, Program Implementation and Administration, Dhaka, Bangladesh

Residential support for HIV-positive street-involved girls in Ukraine
H. Skipalska1,2, S. Hodgdon3, I. Semenko1, O. Rudneva4
1HealthRight International Representative Office in Ukraine, Kyiv, Ukraine, 2Ukrainian Foundation for Public Health, Kyiv, Ukraine, 3HealthRight International, New York, United States, 4ANTIAIDS Foundation, Kyiv, Ukraine

Working it: an evaluation of new outreach methods to meet the needs of male sex worker health in NSW by Sex Workers Outreach Project NSW
C. Cox1, J. McMillan2
1Sex Workers Outreach Project NSW, Male Project, Surry Hills, Australia, 2Sex Workers Outreach Project NSW, Sydney, Australia

Regular sex partners to sex workers a "forgotten population" with HIV/STI burden
M. Akolo1, J. Kimani2, L. Gelmon2
1University of Nairobi, Nairobi, Kenya, 2University of Nairobi/Manitoba, Nairobi, Kenya

Sexual and reproductive health in adolescent female sex workers: Kunming, China
X.-D. Zhang1, M. Lim2, E. Kennedy3, Y. Yang4, L. Li5, Y.-X. Li6, M. Temmerman1, S. Luchters3
1Ghent University, International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent, Belgium, 2Burnet Institute, Centre for Population Health, Melbourne, Australia, 3Burnet Institute, Centre for International Health, Melbourne, Australia, 4Kunming Infectious Diseases Hospital, Department of AIDS & TB Treatment and Care, Kunming, China, 5Kunming Women and Children Health Centre, Department of Primary Care, Kunming, China, 6Kunming Women and Children Health Centre, Department of AIDS Prevention and Care, Kunming, China

Moderated discussion

Powerpoints presentations
Prevention of HIV among bonded sex workers through establishing human rights - Joyeeta Saha Piwoo

Residential support for HIV-positive street-involved girls in Ukraine - Olga Rudneva

Working it: an evaluation of new outreach methods to meet the needs of male sex worker health in NSW by Sex Workers Outreach Project NSW - Cameron Cox

Regular sex partners to sex workers a "forgotten population" with HIV/STI burden - Maureen Akolo

Sexual and reproductive health in adolescent female sex workers: Kunming, China - Xu-Dong Zhang

Rapporteur report

Track D report by Shalini Bharat

This session described interventions among female and male sex workers, employing different approaches (eg., via social media, promoting human rights and engaging brothel keepers) and addressing needs beyond HIV (eg., addressing housing needs). Two papers reported findings based on quantitative studies with sex worker populations. Presentations focused on the especially vulnerable and ‘less reached’ populations of adolescent bonded sex workers (Bangladesh), street-involved girls/women (Ukraine), adolescent female sex workers (China), male sex workers  (Sydney) and regular male partners of female sex workers (Kenya).

Piwoo et al. ( Prevention of HIV among bonded sex workers in Bangladesh) reported on an intervention focused on adolescent bonded sex workers in Bangladesh which besides empowering the sex workers with knowledge about human rights and life skills education, and ensuring regular condom supply, also engaged brothel keepers and management through dialogues about financial accountability to SWs and about the importance of keeping them free of HIV. Success was reported in terms of HIV-free sex workers in the intervention brothels and the ability of a majority of them to negotiate with both clients and the brothel keepers.

Skipalska et al., Residential support for HIV positive street involved girls in Ukraine described a service-model of continuum of care for especially vulnerable street –involved homeless, HIV positive girls and women in Kiev, Ukraine, that includes a half-way house besides an outreach, drop-in-centre and supported referrals activities. Women and girls accessing half-way house were able to retain parental rights to their children and a few were transitioned to independent living with their children. The intervention meets the shelter and child care needs of especially vulnerable street -involved HIV positive girls and women.

Cox et al. (An evaluation of new outreach methods for male sex workers in Sydney) described new methods of engagement with male sex workers in Sydney via social media platform and commercial hook up sites frequented by them, obtaining peer profiles on several internet sites, establishing Twitter stream, a Facebook page, and Tumblr log . These online outreach methods were reported to be ‘highly’ effective in contacting and in disseminating information and resources to male sex workers in a context where sex work is decriminalised and sex workers want anonymity and autonomy in their profession.

Akolo et al.( Regular sex partners of Sex workers “a forgotten” population) presented baseline data from a prevention program that aims to support SWs to help their ‘regular male sex partners’ through referral letters in accessing services for HIV/STI screening, care and treatment, and consistent condom use. Data highlight that regular partners are a key population for prevention interventions. Of the 732 regular male partners included in base line, 139 and 239 reported other casual and regular sex partners and low condom use with them, and 4.9% tested HIV positive while only 2.2% demonstrated correct condom use.
Zhang et al (Sexual and reproductive health of adolescent female sex workers in China) reported findings of a quantitative study on the SRH needs of 310, 15-20 year old women self -reporting selling sex for money in Kunming, China. Unplanned pregnancy was associated with intimate partner violence, frequent alcohol use, and inconsistent condom use with non-paying partners, while unmet need for contraception with being married and alcohol use.Study draws attention to the need to promote knowledge about dual protection measures and address broader issues of alcohol use and domestic violence in the lives of adolescent sex workers.

Audience comments

Issues were raised about doing research and out reach work with adolescents when country laws did not permit direct involvement with them and authors conceded difficulties of working under non-supportive legal frameworks and having to bypass them. Discussion was also around challenges of adopting social media and other new approaches to reach sex workers in countries with poor communication network and populations with low literacy (truck drivers, IDUs), trafficked sex workers and criminalised sex work, underscoring the inherent contrast in contexts in which SW interventions must be designed. Information was also sought on the process of empowering sex workers and brothel keepers in Bangladesh, the sustainability of approaches like half-way houses in Ukraine, and dealing with the immense diversity in sex workers population across the globe.

Session Recommendations

Bonded, adolescent and homeless sex workers are especially vulnerable with no or very poor access to services. Interventions described in the session addressed the broader risk environment in which these sex workers live and operate and evaluated success in structural terms. Documenting the context and process of implementing these interventions is important to develop insights for designing such interventions in different other settings and for other less reached key populations, such as IDUs.  Issues needing attention are: sustainability of such interventions and their evaluation for impact in reducing sex workers’ vulnerability due to intersecting structural factors. The demonstrated feasibility of using social media for out reach work with metro city sex workers could change the way interventions are planned in future, however, the limited applicability of this approach in many other settings is critical to note. 


    The organizers reserve the right to amend the programme.