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Paulo Longo Research Initiative
PLRI aims to consolidate ethical, interdisciplinary scholarship on sex work to inform activism and advocacy that will improve the human rights, health and well being of sex workers.
Mary Honeyball, Labour’s Spokesperson on the European Parliament’s Women’s Rights and Gender Equality Committee, has been a vocal supporter of anti-sex work legislation and has written a report to the European Parliament recommending the Swedish Model, which criminalises the purchase of sex. In a blog leading up to the discussion Alex Bryce and other prominent service providers in the UK condemn the move and encourage the Parliament to listen to sex workers. Year of publication: 2014 Theme: Human Rights and Law Research Ethics and Methods Author: Alex Bryce; Rosie Campbell and others Relevant URL: http://www.totalpolitics.com/blog/428222/a-response-to-mary-honeyball.thtml
Looking upstream to prevent HIV transmission: can interventions with sex workers alter the course of HIV epidemics in Africa as they did in Asia?
High rates of partner change in ‘upstream’ sex work networks have long been recognized to drive ‘downstream’ transmission of sexually transmitted infections (STIs). We used a stochastic microsimulation model (STDSIM) to explore such transmission dynamics in a generalized African HIV epidemic. METHODS:: We refined the quantification of sex work in Kisumu, Kenya, from the 4-cities study. Interventions with sex workers were introduced in 2000 and epidemics projected to 2020. We estimated the contribution of sex work to transmission, and modelled standard condom and STI interventions for three groups of sex workers at feasible rates of use and coverage. RESULTS:: Removing transmission from sex work altogether would have resulted in 66% lower HIV incidence (range 54-75%) and 56% lower prevalence (range 44-63%) after 20 years. More feasible interventions reduced HIV prevalence from one-fifth to one-half. High rates of condom use in sex work had the greatest effect, whereas STI treatment contributed to HIV declines at lower levels of condom use. Interventions reaching the 40% of sex workers with most clients reduced HIV transmission nearly as much as less targeted approaches attempting to reach all sex workers. Declines were independent of antiretroviral therapy rollout and robust to realistic changes in parameter values.
The PLRI website was established in 2010 with limited funding which was not sustained so updates were intermittent after 2012. The good news is that important work of maintaining the website will resume in 2014 thanks to a team of independent volunteers. Nothing without us ! Year of publication: 2014 Theme: Research Ethics and Methods
Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis
This is an important study of the epidemiological literature on female sex workers. It shows us that for the first 30 years HIV affected and killed huge numbers of women who sell sex. Although the article does not make for happy reading we can take great comfort in knowing that the information here is about things that happenned before there was widespread access to ARV treatment. Because antiretroviral treatment both prevents people dying of HIV illnesses and prevents others contracting HIV from positive people who take ARVS the future of the HIV pandemic is very different to this past history. How different will depend, as the authors say, on changing laws around sex work and on expanding prevention programmes, (assuming that by ‘prevention’ they mean ‘prevention, care and treatment’) Cheryl Overs Author Abstract Female sex workers are a population who are at heightened risk of HIV infection secondary to biological, behavioural, and structural risk factors. However, three decades into the HIV pandemic, understanding of the burden of HIV among these women remains limited. We aimed to assess the burden of HIV in this population compared with that of other women of reproductive age. We searched PubMed, Embase, Global Health, SCOPUS, PsycINFO, Sociological Abstracts, CINAHL
Why do development projects, and AIDS projects in particular, take the forms they do? In this essay we argue that it is because the conflicting interests and world views of the key actors involved—donors, brokers, and villagers—leave only a narrow range of themes and practices that can “work” on the ground. By “work” we do not mean, in the AIDS case, that they help prevent HIV transmission; indeed, the non-medical approaches to HIV prevention are largely ineffectual. What needs to be explained is why such approaches are nonetheless repeated so consistently. We show that these themes and practices work in the sense that they satisfy the varied agendas of the major actors sufficiently to sustain their day-to-day cooperation. Understanding these actors and their varying interests and world views is key to understanding why development projects rely on such a narrow repertoire of approaches, particularly the arcane and ubiquitous practice of training. HIV prevention projects are our case in point. Theme: Economics and Development watkins and swidler.pdf Author: Susan Cotts Watkins and Ann Swidler
This publication describes Avahan’s HIV prevention interventions with male clients of female sex workers, who are the primary bridge population in India. This publication describes how Avahan implemented these programs rapidly and on a large scale, taking into account the particular social and cultural factors relevant to clients of sex workers in India. It also outlines some of the challenges, progress to date, and lessons learned Year of publication: 2014 Theme: Health and HIV closing-the-bridge.pdf Author: The Bill and Melinda Gates Foundation Relevant URL: https://docs.gatesfoundation.org/documents/closing-the-bridge.pdf
Vulnerability to HIV infection among female drug users in Kathmandu Valley, Nepal: a cross-sectional study
Women who use drugs are extremely vulnerable to HIV and sexually transmitted infections (STIs), but studies on risk behaviours and HIV infection among female drug users are limited in Nepal. Methods In this cross-sectional study conducted between September 2010 and May 2011, HIV prevalence and risk factors for HIV infection were investigated among female drug users recruited in drop-in centres, parks and streets in the Kathmandu Valley. The participants completed face-to-face interviews for a structured questionnaire, HIV pre-test counselling, specimen collection for HIV test and they were provided with their results at post-test counselling. Results A total of 269 female drug users were recruited, of whom 28% were found HIV positive; the majority (78% ) being injecting drug users and aged below 25?years (57%, 155). Nearly half (137) of the total participants had shared needles or syringes in the past month, and 131 and 102 participants were involved in commercial or casual sex respectively with only half or less of them having had used condoms in the last 12?months. In multivariate analysis the variables associated with HIV infection included: (a) older age; (b) history of school attendance; (c) frequency of sharing of injection instruments; and (d) unsafe sex with commercial
HIV, Syphilis, and Behavioral Risk Factors among Female Sex Workers before and after Implementation of Harm Reduction Programs in a High Drug-Using Area of China
Two cross-sectional surveys were conducted among FSWs before and after harm reduction programs were launched in Xichang city, Sichuan province. The first and second cross-sectional surveys were conducted in 2004 and 2010, respectively. Temporal changes in odds of HIV, syphilis, and behavioral risk factors were assessed by multivariable logistic regression while controlling for socio-demographics. The study found that harm reduction strategies may be an effective means of reducing unprotected sex with clients among FSWs. Future research is needed to better target both FSWs and IDUs and interrupt bridging networks for HIV transmission in high drug-using areas of China. Year of publication: 2014 Theme: Health and HIV Author: L Zhang and others Relevant URL: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0084950
Cross-sectional studies were conducted biennially among 400 SW recruited in Catalonia (Spain) in the street, flats and clubs. In addition to an anonymous questionnaire, oral fluid samples were collected to estimate HIV prevalence. The percentage of SW who used condoms inconsistently with clients (past 6 months) increased from 5.1% in 2005 to 9.9% in 2011; this percentage also increased with steady partners (86.2% in 2005 to 94.4% in 2011.The prevalence of self-reported sexually transmitted infections (STI) increased from 14% in 2005 to 20.6% in 2011. The prevalence of HIV held constant over the years (about 2%), being higher in Spanish women (14.7% in 2011). The prevalence of HIV in SW remained stable over the years, being higher in Spanish SW. The increase in unprotected sex and in the prevalence of self-reported STI among SW from 2005 to 2011 highlights a possible relaxation in preventive behaviors in this group. Interventions to reduce the transmission of these infections, as well as unwanted pregnancies, should continue in Catalonia in SW. Author: C Folch and others
PLRI WEBSITE NEWS – 2014