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Court-based research: collaborating with the justice system to enhance STI services for vulnerable women in the US http://t.co/3vEaFQVO
The fractal queerness of non-heteronormative migrant #sexworkers in the UK by Nick Mae http://t.co/X7oGFeDI
‘only 31% of the sample of indirect sex workers reported having been engaged in commercial sex in the last 12 months’
Old but good. Violence and Exposure to HIV among #sexworkers in Phnom Penh http://t.co/rkrRGiBa
Someone is Wrong on the Internet: #sex workers’ access to accurate information 

Health and HIV

  • Contraceptive needs of female sex workers in Kenya – A cross-sectional study – 2011

    Article in the European Journal of Contraception and Reproductive Health Care, June 2011, Vol. 16, No. 3 , Pages 173-182. 

    Female sex workers (FSWs) are thought to be at heightened risk for unintended pregnancy, although sexual and reproductive health interventions reaching these populations are typically focused on the increased risk of sexually transmitted infections. The objective of this study of FSWs in Kenya is to document patterns of contraceptive use and unmet need for contraception.

  • Cost and Performance of HIV/AIDS Control Workers Outreach Program to Direct Female Commercial Sex Workers in Cambodia – 2011

    This study was undertaken to measure the costs and performance of an outreach programme to direct female commercial sex workers in Cambodia. The study consists of two parts, first a review of all activities of the programme in 20 provinces and 2 major cities in order to calculate the total costs incurred by the programme within its first year of intervention. Second is an analysis of behavioral change of commercial sex workers based on data from a Behavioral Survey.

  • Cost effectiveness of targeted HIV prevention interventions for female sex workers in India – 2011

    Article in Sex. Transm. Infect. 2011;87:263.

    Objective To ascertain the cost effectiveness of targeted interventions for female sex workers (FSW) under the National AIDS Control Programme in India.

  • Coverage of Four Key Populations at the 2010 International AIDS Conference: Implications – 2011

    The Global Forum on MSM & HIV reviewed every abstract and session at the 2010 International AIDS Conference. Their analysis revealed a ‘gross underrepresentation’ of key populations (men who have sex with men, sex workers, transgender people and people who use drugs) across the 2010 conference programme.

    Unfortunately this report does not address the reasons why  sexual minorities were excluded or examine any of the mechainics of how it came about. Nor does it offer any suggestions for the future.

  • CREA research on violence against women in India, Bangladesh and Nepal – 2011

    A research study on violence against lesbian women, female sex workers, and disabled women in three countries in South Asia—Bangladesh, India, and Nepal. The study investigated the hypothesis that women who are outside the mainstream of the South Asian society suffer high rates of violence and are often unable to seek and receive protection from State agencies.

  • Creating a different international HIV response for young people – 2011

    This paper demonstrates that certain notions of young people in the HIV and AIDS response reveal an overly generalised understanding of ‘youth’ that does not reflect a realistic view of young people’s identity and lives. Faulty stereotypes of ‘youth’ – such as the perceptions that young people are necessarily victims or risk-takers – result in many HIV programmes based on generalisations about young people, rather than their actual needs and realities.

  • Declaration from the UN High Level Meeting on AIDS 2011 – 2011
  • Different stage, different performance: the protective strategy of role play on emotional health in sex work – 2011

    An article in Social Science & Medicine Volume 72, Issue 7, April 2011, Pages 1177-1184.

  • Diversity of commercial sex among men and male-born trans people in three Peruvian cities – 2011

    An article in Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, Volume 13, Issue 10.

    In Peru, commercial sex involving men and male-born travestis, transgenders and transsexuals (CSMT) is usually represented as a dangerous practice carried out on the streets by people experiencing economic hardship and social exclusion. However, in reality little is known about the complexities of this practice in Peru.

  • Does HIV testing reduce transmission risks in the market for commercial sex? – 2011

    This paper examines how beliefs about own and partner’s HIV status influence willingness to engage in risky sexual behaviour in the market for commercial sex in developing countries. Especially, we look at the e¤ect of one intervention that has the potential to alter beliefs, namely HIV testing, and how testing influences a commercial sex worker’s decision to sell unprotected sex. We analyse the hypothesis that HIV testing reduces transmission risks by applying the game theoretical concept of perfect Bayesian equilibrium in a model with double-sided asymmetric information.

  • Treatment as Prevention: How might the game change for sex workers? – 2011

    “What drives continued expansion of the pandemic is not the absence of effective preventative technologies but discrimination, exploitation and repression of certain social groups,” Dr Peter Piot.

    This article looks at the potential impact of partially effective, non contraceptive HIV prevention methods on sex workers in the light of recent news that anti-retroviral treatment (ART) by people with HIV substantially protects their HIV-uninfected sexual partners from acquiring HIV infection, with a 96 percent reduction in risk of HIV transmission.

  • “Over here, it’s just drugs, women and all the madness”: The HIV risk environment of clients of female sex workers in Tijuana, Mexico – 2011

    HIV vulnerability depends upon social context. Based in broader debates in social epidemiology, political economy, and sociology of health, Rhodes’ (2002) “risk environment” framework provides one heuristic for understanding how contextual features influence HIV risk, through different types of environmental factors (social, economic, policy, and physical) which interact at different levels of influence (micro, macro).

  • A Psychosocial Study of Male-to-Female Transgendered and Male Hustler Sex Workers in São Paulo, Brazil – 2011

    This study examined sociodemographic variables, personality characteristics, and alcohol and drug misuse among male sex workers in the city of Santo André, São Paulo, Brazil. A total of 45 male-to-female transgender sex workers and 41 male hustlers were evaluated in face-to-face interviews at their place of work from 2008 to 2010. A “snowball” sampling procedure was used to access this hard-to-reach population.

  • A study on morbidity and psychosocial behaviour of children of commercial sex workers of North Bengal, India – 2011

    Article in the Health 2011; 2(2):37-40.

    Background: Children of commercial sex workers (CSW) are deprived from almost all the rights of the society. More attention is paid to the CSWs but their children are neglected. This study was conducted to estimate the morbidity and psychosocial behaviour of children of CSWs and their needs.

    Methods: A community-based cross-sectional study was conducted.

  • Acceptability of HPV vaccine and HPV prevalence among female sex workers in Lima, Peru – 2011

    While it may not be financially possible at this time to vaccinate all women in developing countries against HPV, a focus on high risk populations may be achievable, and may provide secondary protection to the general population. We examined sexual behaviors, cervical abnormalities, HPV prevalence and vaccine acceptability among female sex workers (FSWs).

  • Adolescent female sex workers: invisibility, violence and HIV – 2011

    Article in the Arch Dis Child doi:10.1136/adc.2009.178715.

  • Advancing sexual health and human rights in the Western Pacific – 2011

    Widespread criminalization of sex work has had the effect of undermining the sexual health of sex workers, for instance by preventing them from accessing health care services for fear of criminal prosecution if found to be a sex worker. Moreover, laws permitting mandatory HIV or STI testing of sex workers and mandating disclosure of private health information to employers sanction direct interference in the private lives of sex workers. Extract from report

  • Ain’t I a Woman? A Global Dialogue between the Sex Workers’ Rights movement and the Stop Violence Against Women Movement – 2011

    This is a resource written by Bishakha Datta and sponsored by CASAM and CREA. The report documents a meeting entitled “Ain’t I A Woman? A Global Dialogue between the Sex Workers Rights Movement and the Stop Violence against Women Movement” from 12-14 March 2009 in Bangkok, Thailand. 

    The report features the presentations from many great speakers including , Ruth Morgan Thomas, Anna-Louise Crago, Kaythi Win, Hua Sittipham Boonyapisomparn, Swapna Gayen and Meenakshi Kamble,Cheryl Overs and  Meena Seshu

  • An assessment of sex work in Swaziland: barriers to and opportunities for HIV prevention among sex workers – 2011

    The HIV situation in virtually all southern African countries is a generalised epidemic. Despite the fact that almost all adult age and social groups have high HIV prevalence estimates, sex workers are disproportionally affected, with prevalence estimates higher than the general population. In a qualitative study of 61 male and female sex workers in Swaziland, we found that while poverty drove many into sex work, others reported motivations of pleasure or “sensation seeking”, and freedoms from the burden of marriage as perceived benefits of sex work.

  • An Exploratory Study of the Social Contexts, Practices and Risks of Men Who Sell Sex in Southern and Eastern Africa – 2011

    The aim of the research presented in this report was to explore the social contexts, life experiences, vulnerabilities and sexual risks experienced by men who sell sex in Southern and Eastern Africa, with a focus on five countries; Kenya, Namibia, South Africa, Uganda and Zimbabwe. It sought to better understand differing and similar socio-cultural scenarios and personal life stories of male sex workers in these countries and to improve the representation of male sex workers in relevant regional organisations, particularly within the African Sex Workers Alliance (ASWA).

  • Fiji Cracks Down on Sex work – 2011

    A report published today by the University of NSW says sex workers, especially in Lautoka, the centre of Fiji’s sugar industry, north of Nadi, have been rounded up by the military and subjected to sleep deprivation, humiliation and forced physical labour.

    Karen McMillan, a researcher with the International HIV Research Group at UNSW, said the sex workers were held in outdoor pens at an army base, woken every three hours and made to do duck-walks and squat in the mud.

  • First report on sexually transmitted infections among trans (male to female transvestites, transsexuals or transgender) and male sex workers in Argentina: high HIV, HPV, HBV, and syphilis prevalence – 2011

    Article in the International Journal of Infectious Diseases, Volume 15, Issue 9, September 2011, Pages e635-e640.

    Due to the scarce data on the prevalence of sexually transmitted infections (STIs) among male-to-female trans-sex workers (TSW) and male sex workers (MSW) in Argentina, the present study aimed to estimate the incidence of human immunodeficiency virus (HIV), and the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum. Human papillomavirus (HPV) and Chlamydia trachomatis infections were tested among TSW.

  • From rice fields to red light districts: An economic examination of factors motivating employment in Thailand’s sex industry – 2011

    This research identifies factors that distinguish rural women who have migrated to Bangkok for the purpose of enhancing their economic wellbeing by engaging in the sex industry and those who have stayed in their rural communities and are not engaged in the sex industry. The research used primary data collected through interviews in the red light districts of Bangkok and Pattaya and in villages in rural provinces in Thailand. A total of 100 respondents provided information for the study: 55 percent from the red light districts and the remainder from the provinces. 

  • Gay community, sex workers, health care providers, the police and legal representatives join in to mark IDAHO – 2011

    Kenyans, drawn from the gay and lesbian community, male and female sex workers, representatives of the police force, health care providers and also legal professionals came together to mark the International Day Against Homophobia and Transphobia (IDAHO)in Kisumu, Kenya.

  • Harsh realities: Reasons for women’s involvement in sex work in India – 2011

    This study, in the Journal of AIDS and HIV Research Vol. 3(9), pp. 172-179, documents the reasons and processes for involvement of women into sex work in India. The study is based on in-depth interviews with a cross-section of commercial sex workers in four Indian states – Maharashtra, Tamil Nadu, Karnataka and Andhra Pradesh. It shows that most women enter sex work due to a complex set of reasons as opposed to any one single over-riding reason.

  • HIV and Law in China – 2011

    The Chinese government uses the traditional strategy of implementing strict laws regarding sex work with the intention of preventing risk behaviours.

  • HIV and Sex Work in Cambodia – 2011

    Cambodia is internationally recognized for having successfully reduced its HIV prevalence among the general population from about 3% in 1997 to 0.7% in 2009. Sex work played a significant role in the spread of the HIV epidemic during the nineties. Since 1999, HIV prevalence has declined among direct and indirect sex workers, although levels remain high. The 100% condom use promotion strategy has been credited for having played a major role in the decline of HIV.

  • HIV and Sex Work in Myanmar – 2011

    Myanmar has one of the largest HIV epidemics in Asia. The first case of HIV was detected in 1988 while the first AIDS case was reported in 1991. HIV prevalence among the general population reached its peak at 0.94% in the year 2000 and was estimated to be 0.61% in 2009. The estimated number of adults and children living with HIV in 2009 was 238,000 (with a range of 160,000 to 320,000).

  • HIV treatment as prevention—it works – 2011

    Article in the Lancet,  Volume 377, Issue 9779, Page 1719, 21 May 2011.

    This article gives more detail on the recent trial of HIV treatment as a form of HIV prevention.

  • HIV Treatment reduces transmission by 96% – 2011

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    The news that people living wtih HIV who are on antiretoviral therapy will have a huge effect on HIV programming for sex workers. It  suggests that ARV therapy rather than condom promotion may account for the huge reduction in HIV transmissions during commercial sex over recent years.  It also raises the question of whether voluntary testing should be replaced by routine testing. What it definitely raises is the importance of free access to ARVs, nutrition and adherence support for all. 

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.

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