Prevention and Treatment of HIV and other Sexually Transmitted Infections for Sex Workers in Low- and Middle-income Countries: Recommendations for a Public Health Approach

Sex workers in many places are highly vulnerable to HIV and other sexually transmitted infections due to multiple factors, including large numbers of sex partners, unsafe working conditions and barriers to the negotiation of consistent condom use. Moreover, sex workers often have little control over these factors because of social marginalization and criminalized work environments. Alcohol, drug use, and violence in some settings may further exacerbate their vulnerability and risk.

The objective of this document is to provide technical recommendations on effective interventions for the prevention and treatment of HIV and other STIs among sex workers and their clients. The guidelines are designed for use by national public health officials and managers of HIV/AIDS and STI programmes, nongovernmental organizations including community and civil society organizations, and health workers. Regions and countries are encouraged to adapt these guidelines to support acceptable services for sex workers taking into account the epidemiological and social context. These guidelines may also be of interest to international funding agencies, the scientific media, health policy-makers and advocates.

Year of publication:

2012

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Consultation of Sex Workers (PICO Questions) and Report

The World Health Organization (WHO) is developing guidelines for evidence-based interventions for the prevention and treatment of HIV and other sexually transmitted infections (STIs) in low- and middle-income countries. As a global partner to the WHO in this process, the Global Network of Sex Work Projects oversaw a civil society consultation of sex workers commissioned by the WHO to gather feedback on proposed guidelines. This report contains the findings from that consultation and was submitted to the WHO.

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‘SWIT’ – Implementing Comprehensive HIV/STI Programs with Sex Workers (Policy Brief)

This tool, commonly abbreviated as ‘SWIT,’ is the product of collaboration among sex workers, service providers, researchers, government officials, and NGOs from around the world. Its development was guided by WHO, UNFPA, UNAIDS, NSWP, the World Bank, and development partners from the US, including the Bill & Melinda Gates Foundation. The purpose of this tool is to describe approaches and principles to building programmes. Guidance is provided on how to implement the recommended health-care interventions for HIV prevention, treatment and care, how to manage programmes, and how to build the capacity of sex worker organizations. Throughout the document are case examples from programmes around the world, highlighting specific aspects related to sex worker programming that have worked well in their contexts. These case examples illustrate how an issue or challenge has been addressed, and to inspire ideas about approaches that could work in the reader’s own context.

The full-text document is also available.

Year of publication:

2013

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Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach

These consolidated guidelines provide guidance on the diagnosis of HIV infection, the care of people living with HIV, and the use of antiretroviral (ARV) drugs for treating and preventing HIV infection. They are structured along the continuum of HIV testing, care and treatment. Behavioural, structural and biomedical interventions that do not involve the use of ARV drugs are not covered in these guidelines. The 2013 consolidation process combines and harmonizes recommendations from a range of WHO guidelines and other documents, including the 2010 guidelines on using antiretroviral therapy (ART) for HIV infection in adults and adolescents, in infants and children, and for treating pregnant women living with HIV and preventing HIV infection in infants. Comprehensive guidance is now provided on using ARV drugs across age groups and populations of adults, pregnant and breastfeeding women, adolescents, children and key populations. The guidelines also aim to consolidate and update clinical, service delivery, and programmatic guidance.

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Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages

This generic rapid assessment tool, published in 2009 by multiple NGOs and civil society groups, covers a broad range of linkages issues, such as policy, systems, and services. By design, it aims to provide a guide for assessing linkages that can be adapted as needed to regional or national contexts based on a number of factors. Countries are encouraged to review the questions and the scope of the assessment and modify it according to the local situation.This tool can be used as a “standalone” activity or can be integrated into a larger review of the national response. It focuses on questions which can be answered in desk reviews and individual or group interviews (Policy and Systems sections), and individual interviews of various service providers and clients (Service delivery section).

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HIV Discordant Couples: An Exploratory Study Insights from South Africa, Tanzania and the Ukraine

This document summarizes the findings of an exploratory study on coping strategies and life choices of couples in South Africa, Tanzania, and the Ukraine living in long-term serodiscordant relationships (i.e., couples in which one partner is HIV-positive and the other partner HIV-negative) undertaken by the Global Network of People Living with HIV (GNP+), and funded by World Health Organization (WHO). GNP+ worked collaboratively with South African researchers at the Centre for Health Policy at the University of the Witwatersrand and the Human Sciences Research Council (HSRC) to gather information on serodiscordant couples, with the aim of learning more about the strategies and choices used by serodiscordant couples to sustain their relationships, make sexual and reproductive choices, maintain their health, and avoid HIV transmission.

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