Tagged: sex workers

  • Inextricable links: HIV and human rights

    The AIDS epidemic has been characterized by the stigma and discrimination of people who are all too often already on the margins of society.

    This marginalization has made it more difficult for millions of people on every continent to access much-needed HIV prevention, treatment, care and support services. As we recognize International Human Rights Day on Dec. 10, we cannot lose sight of the inextricable link between HIV and human rights, which should be the cornerstone of our response to and understanding of this epidemic.

    And there is, perhaps, reason for cautious optimism. Despite some policy gains and increased global attention, HIV continues to disproportionately affect “key populations” — men who have sex with men, sex workers, people who inject drugs and transgender people. UNAIDS estimates that 40 to 50 percent of new adult HIV infections worldwide occur among key populations and their partners.

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  • Research on key populations leads Botswana to smarter HIV prevention

    At approximately 18 percent, the prevalence of HIV in Botswana’s general population is one of the highest in the world. As a result, national HIV prevention efforts have focused more intensively on the general population than on other populations. Little is known about key populations, such as female sex workers and men who have sex with men, whose behaviors are both stigmatized and illegal in Botswana.

    In 2012, the Botswana Ministry of Health used an integrated behavioral and biological surveillance survey to estimate population sizes and prevalence of HIV and sexually transmitted infections (STIs) among female sex workers and men who have sex with men. The study was historic. For the first time, it showed the HIV and STI burden among these two key populations and raised awareness about how they might have contributed to the generalized HIV epidemic.

    The survey, carried out with technical assistance from FHI 360 through the Preventive Technologies Agreement (funded by the U.S. Agency for International Development), uncovered a population of more than 4,000 female sex workers in the three districts where the survey was conducted. Among these female sex workers, HIV prevalence was 61.9 percent, and the prevalence of gonorrhea and chlamydia were both higher than 10 percent. The female sex workers had a mean of more than seven partners per week, and condom failure, which includes condom breakage and being paid or forced not to use condoms, was common.

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  • Improving HIV testing in targeted populations in India

    At the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, staff from FHI 360’s India office will present a poster on a study that shows improved HIV testing among clients of female sex workers. The study contributes to evidence about what works to strengthen HIV prevention.

    Why focus research on the clients of female sex workers?

    Recent studies from India suggest that the purchase of sex from female sex workers is most predominant in higher HIV-prevalence states, such as Andhra Pradesh, Maharashtra and Tamil Nadu. In India, there is a growing recognition of the importance of considering clients when looking to stop HIV transmission, and a number of prevention efforts under the national program have targeted these clients, most of whom are men.

    Conducting surveys among clients of sex workers is challenging, because clients do not like to be identified. There is also little evidence that establishes clients’ risk of contracting HIV in India. To bridge this gap and to provide invaluable information on HIV trends and risk behavior, FHI 360 designed and managed the largest integrated biological and behavioral assessment (IBBA) for most-at-risk populations in India.

    Collecting evidence to inform HIV programming

    Conducted in 2006 and 2009, this cross-sectional survey interviewed approximately 10,000 clients of sex workers as part of Avahan (the India AIDS initiative). This program, funded by the Bill & Melinda Gates Foundation, gathered evidence to inform future HIV prevention programs in India. The IBBA survey was implemented by the institutes of the Indian Council of Medical Research, and technical support was provided by FHI 360.

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  • Focusing on key populations affected by HIV: A smart investment for greater impact

    In an era of limited resources, HIV prevention, care and treatment efforts need to focus on the smartest investments. This means investing in programs that can have the greatest impact in halting HIV transmission and turning back the epidemic. From a public health perspective, the effective use of resources requires focusing on key populations who have the highest level of HIV infection and tackling the barriers that discourage and prevent them from accessing health systems and services. These populations are broadly defined as sex workers, men who have sex with men, transgender persons and persons who inject drugs.

    As the world gathers at the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, July 20–25, 2014, we have an excellent opportunity to share how investing in evidence-based strategies can change the trajectory of the epidemic once and for all.

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