Health and HIV

For the last 25 years the focus of attention on sex workers health has been HIV. However transgender, female and male sex workers and their families are frequently affected by a range of issues that directly and indirectly affect their wellbeing and impact on public health. 

Sex workers in developing countries are disproportionately affected by illnesses and conditions caused by social exclusion, poverty and gender based violence. Lack of access to  sexual and reproductive health services mean that sex workers of all genders are vulnerable to STIs and women are at greater risk of unwanted pregnancies and unsafe abortion. 

Although the potential for commercial sex to play important roles in expanding HIV epidemics is well recognised, HIV and AIDS-related prevention, treatment and care for sex workers remains inadequate and the specific dynamics of commercial sex in HIV epidemics remains controversial. The same is true of the efficacy and ethics of disease control measures as they apply to sex workers. In recent years controversies have been created by the United States HIV policy which has encouraged the criminalization of sex work in developing countries through conditions of its funding allocations and by the UN which encourages prevention of sex work via poverty reduction. 

Paulo Longo Research Initiative research projects will examine the impact of the architecture of international and national public health interventions and policy. We will map and critique the evolution of established evidence and ‘best practice’ in respect of the health of sex workers and their clients and investigate issues in health policy and programming that affect sex workers. These might include HIV testing policy, new HIV prevention technologies such as microbicides, integration of sexual and reproductive health and HIV services, delivery of sexual and reproductive health services and harm reduction strategies for drug users.

Resources

  • Mobilising community collectivisation among female sex workers to promote STI service utilisation from the government healthcare system in Andhra Pradesh, India - 2012

    Background To assess the association between female sex workers' (FSWs) degree of community collectivisation and self-efficacy, utilisation of sexually transmitted infection (STI) services from government-run health centres in Andhra Pradesh, India.

  • Nigeria: Sex Workers Account for 32 Percent of HIV - 2012

    Commercial sex workers account for 32 per cent of HIV prevalence in Nigeria, the Director-General, National Agency for the Control of AIDS, (NACA), Prof. John Idoko, has disclosed.

    He said this at a press briefing yesterday in Abuja to flag off this year's World AIDS Day commemorated worldwide every December 1.

    According to Idoko, Nigeria is at present the second most burdened with the disease, with about 4.1 per cent of her population, about 6.5 million people living with the virus, after South Africa.

  • Overcoming Legal and Policy Conflicts to Implement Vietnam’s First Classic 100% Condom Use Program (CUP) for Female Sex Workers - 2012

    An Giang Province is one of very few provinces in Vietnam where the predominant (78%)
    mode of HIV transmission is sexual contact. HIV prevalence among female sex workers (FSW) is 8.5%. Condom use has been promoted, but only 67% of entertainment establishment [brothels] FSWs reported consistent condom use with clients.

  • Periodic presumptive treatment of curable sexually transmitted infections among sex workers: recent experience with implementation. - 2012

     Curable sexually transmitted infections (STIs) are common occupational hazards for female sex workers in low-income and middle-income countries. Yet, most infections are asymptomatic and sensitive screening tests are rarely affordable or feasible. Periodic presumptive treatment (PPT) has been used as a component of STI control interventions to rapidly reduce STI prevalence.

  • Periodical Antibiotic Treatment for the Control of Gonococcal and Chlamydial Infections Among Sex Workers in Benin and Ghana: A Cluster-Randomized Placebo-Controlled Trial - 2012

    Background: In resource-poor settings, control of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) among female sex workers (FSWs) is difficult. We sought to determine whether periodical antibiotic treatment (PAT) might be effective in controlling these infections among West African FSWs. Secondary objectives were to determine the impact of PAT on human immunodeficiency virus (HIV) incidence among FSWs and on NG/CT prevalence among their clients.

  • Prevalence and correlates of sexual risk among male and female sex workers in Tijuana, Mexico - 2012

    We investigated prevalence and correlates of sexual risk behaviours among male and female sex workers in Tijuana, Mexico, the busiest border crossing area on the US – Mexico border, analysing survey data from a purposive, cross-sectional sample of male and female sex workers who worked in a range of indoor and outdoor settings. Logistic regression was used to determine factors that were associated with sexual risk-taking, defined as failing to use a condom with last client. In bivariate regression models, gender, work setting (e.g., indoor vs.

  • Prevalence of syphilis infection in different tiers of female sex workers in China: - 2012

    Background

    Syphilis has made a dramatic resurgence in China during the past two decades and become the third most prevalent notifiable infectious disease in China. Female sex workers (FSWs) have become one of key populations for the epidemic. In order to investigate syphilis infection among different tiers of FSWs, a cross-sectional study was conducted in 8 sites in China.

  • Prostitutes + Condoms = AIDS?: Leadership Act, - 2012

    Scholars and field experts have argued extensively that the U.S. policy stating that fund recipients may not promote prostitution is unconstitutional because it compels speech.

    Proposed Rulemaking (NPRM) in the Federal Register to clarify what

  • Rates and determinants of HIV-attributable mortality among rural female sex workers in Northern Karnataka, India - 2012

    Female sex workers (FSWs) have among the highest rates of HIV infection in India. However, little is known about their HIV-specific mortality rates. In total, 1561 FSWs participated in a cohort study in Karnataka. Outcome data (mortality) were available on 1559 women after 15 months of follow-up. To gather details on deaths, verbal autopsy (VA) questionnaires were administered to key informants. Two physicians reviewed the VA reports and assigned underlying causes of death.

  • Sex workers encourage condom use - 2012

    Commemorating World AIDS Day, which fell on Saturday, Dec. 1, commercial sex workers and transvestites in Central Java promoted the use of condoms among their customers in a bid to help prevent the spread of HIV/AIDS.

    In Semarang, prostitutes in the city’s biggest red light district Sunan Kuning (SK) conducted a competition to encourage customers to use condoms. The winner would be named the HIV/AIDS ambassador of the red light district.

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