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Assessment of population-level effect of Avahan, an HIV-prevention initiative in India

Article in the Lancet, Early Online Publication, 11 October 2011. Background The aim of Avahan, the India AIDS Initiative, was to reduce HIV transmission in the general population through large-scale prevention interventions focused on high-risk groups. It was launched in 2003 in six states with a total population of 300 million and a high HIV burden. We assessed the population-level effect of the first phase of Avahan (2003—08). Methods Population prevalence was estimated by use of adjustment factors from the national HIV sentinel surveillance data obtained annually from antenatal clinics. A mixed-effects multilevel regression model was developed to estimate the association

Anal sex, vaginal practices and HIV incidence in female sex workers in urban Kenya: Implications for development of intravaginal HIV prevention methods

Multiple intravaginal HIV prevention methods, including microbicide gels, barriers and intravaginal rings, are in clinical development in Africa. Development of intravaginal HIV prevention products requires an understanding of sexual behavior, sexually transmitted infection (STI) and vaginitis prevalences, and sexual and vaginal practices in potential target populations. We assessed these factors in a cohort of Kenyan female sex workers (FSW). Methods: Women who reported exchanging sex for money/gifts at least 3 times in the past month and were HIV uninfected were enrolled and followed for 6 months. STI prevalence and HIV incidence were analyzed by multivariate logistic regression analysis, controlling for

HIV and Sex Work in Indonesia

Although the prevalence of HIV in the general population is low (0.2%) and is mainly concentrated among injecting drug users (IDUs) in Jakarta, West Java and Bali, the epidemic has now spread to other key populations at higher risk such as non‐injecting partners of IDUs, sex workers and their clients [1]. The number of reported cases attributable to sexual transmission increased from 17.6% in 1987‐1990 to over half of the reported cases in 2009 [3],[4]. The estimated proportion of new HIV infections attributed to sexual transmission is projected to reach 58% by 2014 [5] and 42‐43% of new HIV infection

Poll reveals details of Bogota's prostitution business

A news story by Daniel Brody in the Columbia Reports. The story outlines the findings of an opinion survey of sex workers and their clients in Bogota which was taken by the Mayor’s Office. There is no link to the original source so we cannot comment on the accuracy of the reporting or the methods used. Poll reveals details of Bogota’s prostitution business Daniel Brody A new opinion survey of sex workers and their clients in Bogota has been taken by the Mayor’s Office, providing a fascinating window into the lives of those who toil in and patronize the city’s

Issues Concerning the Informality and Outdoor Sex Work

The objective of this article was to discuss a series of issues pertaining to outdoor sex work practiced by low-income travestis in São Paulo, Brazil. Qualitative methods conducted among this segment of the population revealed sex work as almost inseparable from the existence of travestis as a social group. Among them, the outdoor modality was the most prominent and social stigma was a predisposing factor for their entrance (and permanence) in sex work. The results showed that some of the difficulties they faced regarding work must be understood as a consequence of them being self-employed, informal workers occupying public spaces,

Anna Forbes: From Microbicides to Sex Workers—A Logical Development

An article by Lauren Tuck which originally appeared in Poz Magazine Anna Forbes: From Microbicides to Sex Workers—A Logical Development “Anna Forbes found her calling in 1992 when development of microbicides—usually in the form of topical gels or creams that block sexual transmission of HIV—began attracting notice. Since then she has become widely known for championing microbicides, which might offer women protection without a condom. For 10 years she represented the Global Campaign for Microbicides, working on behalf of disenfranchised women. Now she has moved onto consulting in order to discover new ways to fight HIV—and to broaden her horizons.

Migration & Mobility in the Context of HIV and Sex Work

This is a discussion paper prepared for the 1st Asia and the Pacific Regional Consultation on HIV and Sex Work, 12 – 15 October 2010 in Pattaya, Thailand. Among its recommendations are : 1. Cross border and regional agreements should be developed that protect the rights of sex workers to access health and social services, irrespective of their legal status (as both sex workers and as migrants). 2. Sex workers should be included in meaningful partnerships in relevant infrastructure development projects. Major development projects should include “sex worker impact studies” to obtain information when planning for associated infrastructure needs in target

What makes a structural intervention? Reducing vulnerability to HIV in community settings, with particular reference to sex work

Increasing emphasis is being placed on the need for ‘structural interventions’ (SIs) in HIV prevention internationally. There is great variation in how the concept of SI is defined and operationalised, however, and this has potentially problematic implications for their likely success. In this paper, we clarify and elucidate what constitutes a SI with particular reference to the structured distribution of power and to the role of communities. We summarise the background to the growing emphasis being placed on the concept of SIs in HIV prevention policy, and present ethnographic case-study material from a sex worker’s HIV project in Kolkata, India,

The Role of Housing in Determining HIV Risk among Female Sex Workers in Andhra Pradesh, India: Considering Women's Life Contexts

Recent research on HIV prevention, regardless of the population, has increasingly recognized the relevance of contextual factors in determining HIV risk. Investigating such factors among female sex workers (FSW) is especially relevant in the South Indian state of Andhra Pradesh, where HIV rates are among the highest across Indian states and where HIV has largely affected FSW. Stable housing is a particular contextual challenge experienced by female sex workers in this region (as well as elsewhere); however, local studies have not examined the impact of this issue on HIV risk. In this paper, we examine residential instability, defined as a

Sexual and Reproductive Health and Rights (SRHR) – Including Condom Programming

This discussion paper was developed for the for the 1st Asia and the Pacific Regional Consultation on HIV and Sex Work, 12 – 15 October 2010. Among its recommendations are 1. A human rights based approach should be applied to any HIV program targeting sex workers and their clients. The illegality of sex work in most counties in the region creates an environment that facilitates harassment and hinders the delivery of prevention and care. Programs must build the capacity of sex workers to engage in advocacy with policy makers to ensure protection of their fundamental rights to safe work, fair

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