The Global HIV Epidemics among Sex Workers

Since the beginning of the epidemic sex workers have experienced a heightened burden of HIV. Unfortunately, sex workers’ HIV and health-related risks and rights have often gone unattended and global resource allocation related to HIV prevention, treatment and care has not been based on rigorous analysis in terms of the evidence related to sex work and HIV. To inform an equitable, effective, and sustainable response to HIV which promotes and protects the human rights of sex workers, the following questions were addressed in this analysis, focusing largely on female sex workers from lower and middle income countries:

What is the global burden of HIV among sex workers? How do sex worker HIV burdens compare to the general population? How does this vary by region?
How does the policy and social context shape sex workers’ HIV risk across geographic settings? How does this context influence the provision and coverage of HIV services?
To what extent can comprehensive HIV prevention at-scale among sex workers modify HIV transmission dynamics among sex workers and the general population?
What are the most cost-effective HIV prevention, treatment, and care interventions in the context of sex work? What combinations of services are most cost-effective?
Given this evidence, what are the implications for allocative efficiency in HIV prevention programs?
How does violence against sex workers affect their health and human rights and HIV transmission dynamics among sex workers and the general population across settings?
What has been the role of sex worker leadership in promoting the human rights of and reducing the burden of and risks for HIV infection among sex workers across contexts?

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

Media:

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Prise en compte du commerce du sexe, des hommes ayant des rapports sexuels avec des hommes et des personnes transgenres dans le contexte de l’épidémie de vih

Il est indispensable de cibler correctement l’investissement en faveur de la lutte contre le VIH pour y apporter une réponse efficace. Cibler les bonnes populations et les bonnes interventions à la bonne échelle n’est pas chose aisée. Les stratégies et programmes nationaux ont souvent omis de prendre en compte les populations marginalisées, comme les professionnels du sexe, les hommes ayant des rapports sexuels avec des hommes, les personnes transgenres et les consommateurs de drogues, empêchant ainsi les pays d’endiguer les épidémies qui les frappent. Par ailleurs, certains environnements juridiques et politiques influencent la trajectoire de l’épidémie dans les pays et vont même jusqu’à représenter une violation des droits de l’homme en criminalisant les comportements de ces populations-clés et/ou en créant des barrières empêchant l’accès aux services capables de réduire la vulnérabilité au VIH.

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