#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs


There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection “Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers” highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.


Vyšlo v časopise: HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs. PLoS Med 12(6): e32767. doi:10.1371/journal.pmed.1001808
Kategorie: Collection Review
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001808

Souhrn

There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection “Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers” highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.


Zdroje

1. Ghys PD, Diallo MO, Ettiegne-Traore V, Kale K, Tawil O, Carael M, et al. Increase in condom use and decline in HIV and sexually transmitted diseases among female sex workers in Abidjan, Cote d'Ivoire, 1991–1998. AIDS (London, England). 2002;16(2):251–8. 11807310

2. Ghys PD, Diallo MO, Ettiegne-Traore V, Satten GA, Anoma CK, Maurice C, et al. Effect of interventions to control sexually transmitted disease on the incidence of HIV infection in female sex workers. AIDS (London, England). 2001;15(11):1421–31. 11504964

3. Laga M, Alary M, Nzila N, Manoka AT, Tuliza M, Behets F, et al. Condom promotion, sexually transmitted diseases treatment, and declining incidence of HIV-1 infection in female Zairian sex workers. Lancet. 1994;344(8917):246–8. 7913164

4. Levine WC, Revollo R, Kaune V, Vega J, Tinajeros F, Garnica M, et al. Decline in sexually transmitted disease prevalence in female Bolivian sex workers: impact of an HIV prevention project. AIDS (London, England). 1998;12(14):1899–906. 9792391

5. Wi T, Ramos ER, Steen R, Esguerra TA, Roces MC, Lim-Quizon MC, et al. STI declines among sex workers and clients following outreach, one time presumptive treatment, and regular screening of sex workers in the Philippines. Sexually transmitted infections. 2006;82(5):386–91. 17012514

6. Thilakavathi S, Boopathi K, Girish Kumar CP, Santhakumar A, Senthilkumar R, Eswaramurthy C, et al. Assessment of the scale, coverage and outcomes of the Avahan HIV prevention program for female sex workers in Tamil Nadu, India: is there evidence of an effect? BMC public health. 2011;11 Suppl 6:S3. doi: 10.1186/1471-2458-11-S6-S3 22375609

7. Wariki WM, Ota E, Mori R, Koyanagi A, Hori N, Shibuya K. Behavioral interventions to reduce the transmission of HIV infection among sex workers and their clients in low- and middle-income countries. The Cochrane database of systematic reviews. 2012;2:Cd005272.

8. Kerrigan DL, Fonner VA, Stromdahl S, Kennedy CE. Community empowerment among female sex workers is an effective HIV prevention intervention: a systematic review of the peer-reviewed evidence from low- and middle-income countries. AIDS and behavior. 2013;17(6):1926–40. doi: 10.1007/s10461-013-0458-4 23539185

9. Chersich MF, Luchters S, Ntaganira I, Gerbase A, Lo YR, Scorgie F, et al. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services. Journal of the International AIDS Society. 2013;16(1):17980.

10. Moses S, Plummer FA, Ngugi EN, Nagelkerke NJ, Anzala AO, Ndinya-Achola JO. Controlling HIV in Africa: effectiveness and cost of an intervention in a high-frequency STD transmitter core group. AIDS (London, England). 1991;5(4):407–11. 1905555

11. Vickerman P, Terris-Prestholt F, Delany S, Kumaranayake L, Rees H, Watts C. Are targeted HIV prevention activities cost-effective in high prevalence settings? Results from a sexually transmitted infection treatment project for sex workers in Johannesburg, South Africa. Sexually transmitted diseases. 2006;33(10 Suppl):S122–32. 16735954

12. Fung IC, Guinness L, Vickerman P, Watts C, Vannela G, Vadhvana J, et al. Modelling the impact and cost-effectiveness of the HIV intervention programme amongst commercial sex workers in Ahmedabad, Gujarat, India. BMC public health. 2007;7:195. 17683595

13. Prinja S, Bahuguna P, Rudra S, Gupta I, Kaur M, Mehendale SM, et al. Cost effectiveness of targeted HIV prevention interventions for female sex workers in India. Sexually transmitted infections. 2011;87(4):354–61. doi: 10.1136/sti.2010.047829 21447514

14. Borghi J, Gorter A, Sandiford P, Segura Z. The cost-effectiveness of a competitive voucher scheme to reduce sexually transmitted infections in high-risk groups in Nicaragua. Health policy and planning. 2005;20(4):222–31. 15965034

15. Sweat M, Kerrigan D, Moreno L, Rosario S, Gomez B, Jerez H, et al. Cost-effectiveness of environmental-structural communication interventions for HIV prevention in the female sex industry in the Dominican Republic. Journal of health communication. 2006;11 Suppl 2:123–42. 17148102

16. Steen R, Hontelez JA, Veraart A, White RG, de Vlas SJ. Looking upstream to prevent HIV transmission: can interventions with sex workers alter the course of HIV epidemics in Africa as they did in Asia? AIDS (London, England). 2014;28(6):891–9. doi: 10.1097/QAD.0000000000000176 24401648

17. Alary M, Lowndes CM. The central role of clients of female sex workers in the dynamics of heterosexual HIV transmission in sub-Saharan Africa. AIDS (London, England). 2004;18(6):945–7. 15060443

18. Mishra S, Pickles M, Blanchard JF, Moses S, Boily MC. Distinguishing sources of HIV transmission from the distribution of newly acquired HIV infections: why is it important for HIV prevention planning? Sexually transmitted infections. 2014;90(1):19–25. doi: 10.1136/sextrans-2013-051250 24056777

19. Vickerman P, Foss AM, Pickles M, Deering K, Verma S, Eric D, et al. To what extent is the HIV epidemic in southern India driven by commercial sex? A modelling analysis. AIDS (London, England). 2010;24(16):2563–72. doi: 10.1097/QAD.0b013e32833e8663 20852405

20. Cianci F, Sweeney S, Konate I, Nagot N, Low A, Mayaud P, et al. The cost of providing combined prevention and treatment services, including ART, to female sex workers in Burkina Faso. PLoS ONE. 2014;9(6):e100107. doi: 10.1371/journal.pone.0100107 24950185

21. Platt L, Jolley E, Hope V, Latypov A, Hickson F, Reynolds L, et al. HIV in the European Region: using evidence to strengthen policy and programmes—vulnerability and response: synthesis report. Washington, DC: World Bank, 2013.

22. Semaan S, Lauby J, Liebman J. Street and network sampling in evaluation studies of HIV risk-reduction interventions. AIDS reviews. 2002;4(4):213–23. 12555695

23. O'Connor CC, Berry G, Rohrsheim R, Donovan B. Sexual health and use of condoms among local and international sex workers in Sydney. Genitourinary Medicine. 1996;72(1):47–51. 8655167

24. Donovan B, Harcourt C, Egger S, Schneider K, O’Connor J, Marshall L, et al. The Sex Industry in Western Australia. Sydney, Australia: National Centre in HIV Epidemiology and Clincal Research, The University of New South Wales, 2010.

25. Wotton R, editor HIV prevention strategies within the Australian sex worker population—an overview of successful implementation. XVII International AIDS Conference; 2008; Mexico City, Mexico.

26. Rojanapithayakorn W. The 100% Condom Use Programme in Asia. Reproductive health matters. 2006;14(28):41–52. 17101421

27. Arora P, Nagelkerke NJ, Moineddin R, Bhattacharya M, Jha P. Female sex work interventions and changes in HIV and syphilis infection risks from 2003 to 2008 in India: a repeated cross-sectional study. BMJ open. 2013;3(6).

28. Nagelkerke NJ, Jha P, de Vlas SJ, Korenromp EL, Moses S, Blanchard JF, et al. Modelling HIV/AIDS epidemics in Botswana and India: impact of interventions to prevent transmission. Bulletin of the World Health Organization. 2002;80(2):89–96. 11953786

29. Ng M, Gakidou E, Levin-Rector A, Khera A, Murray CJ, Dandona L. Assessment of population-level effect of Avahan, an HIV-prevention initiative in India. Lancet. 2011;378(9803):1643–52. doi: 10.1016/S0140-6736(11)61390-1 21993161

30. Ngugi EN, Wilson D, Sebstad J, Plummer FA, Moses S. Focused peer-mediated educational programs among female sex workers to reduce sexually transmitted disease and human immunodeficiency virus transmission in Kenya and Zimbabwe. The Journal of infectious diseases. 1996;174 Suppl 2:S240–7. 8843254

31. Steen R, Wheeler T, Gorgens M, Mziray E, Dallabetta G (2015) Feasible, efficient and necessary, without exception—working with sex workers interrupts HIV/STI transmission and brings treatment to many in need. PLoS ONE: e0121145.

32. WHO. 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. 2012.

33. UNAIDS. UNAIDS guidance note on HIV and sex work. Geneva: 2012.

34. Thompson LH, Bhattacharjee P, Anthony J, Shetye M, Moses S, Blanchard J. A Systematic Approach to the Design and Scale-up of Targeted Interventions for HIV Prevention among Urban Female Sex Workers. Baglagore, India: 2012.

35. Vuylsteke B, Das A, Dallabetta G, Laga M. Preventing HIV among sex workers. In: Mayer K, Pizer H, editors. HIV prevention: a comprehensive approach. London: Academic Press; 2009.

36. Gaffey MF, Venkatesh S, Dhingra N, Khera A, Kumar R, Arora P, et al. Male use of female sex work in India: a nationally representative behavioural survey. PLoS ONE. 2011;6(7):e22704. doi: 10.1371/journal.pone.0022704 21829486

37. Kumar R, Jha P, Arora P, Dhingra N, HIV ISO. HIV-1 trends, risk factors and growth in India. Burden of Disease in India. 2005:58.

38. Pickles M, Boily M-C, Vickerman P, Lowndes CM, Moses S, Blanchard JF, et al. Assessment of the population-level effectiveness of the Avahan HIV-prevention programme in South India: a preplanned, causal-pathway-based modelling analysis. The Lancet Global Health. 2013;1(5):e289–e99. doi: 10.1016/S2214-109X(13)70083-4 25104493

39. Wilson D. HIV epidemiology: A review of recent trends and lessons. The World Bank: Washington DC. 2006.

40. Carter MW, Kraft JM, Koppenhaver T, Galavotti C, Roels TH, Kilmarx PH, et al. "A bull cannot be contained in a single kraal": concurrent sexual partnerships in Botswana. AIDS and behavior. 2007;11(6):822–30. 17295072

41. Lowndes CM, Alary M, Belleau M, Bosu WK, Kintin DF, Nnorom JA, et al. Characterisation of the HIV epidemic and response in West Africa: Implication for prevention. Washington, DC: World Bank, 2008.

42. Emmanuel F, Blanchard J, Zaheer HA, Reza T, Holte-McKenzie M, team TH. The HIV/AIDS Surveillance Project mapping approach: an innovative approach for mapping and size estimation for groups at a higher risk of HIV in Pakistan. AIDS (London, England). 2010;24:S77–S84 doi: 10.1097/01.aids.0000386737.25296.c4 20610953

43. Blanchard JF, Bhattacharjee P, Kumaran S, Ramesh BM, Kumar NS, Washington RG, et al. Concepts and strategies for scaling up focused prevention for sex workers in India. Sexually transmitted infections. 2008;84 Suppl 2:ii19–23. doi: 10.1136/sti.2008.033134 18799487

44. Emmanuel F, Isac S, Blanchard JF. Using geographical mapping of key vulnerable populations to control the spread of HIV epidemics. Expert review of anti-infective therapy. 2013;11(5):451–3. doi: 10.1586/eri.13.33 23627850

45. MEASURE GIS Working Group. Overview of Issues Concerning Confidentiality and Spatial Data 2008.

46. Sherman JE, Fetters TL. Confidentiality concerns with mapping survey data in reproductive health research. Studies in family planning. 2007;38(4):309–21. 18284045

47. VanWey LK, Rindfuss RR, Gutmann MP, Entwisle B, Balk DL. Confidentiality and spatially explicit data: Concerns and challenges. Proceedings of the National Academy of Sciences of the United States of America. 2005;102(43):15337–42. 16230608

48. Ota E, Wariki WM, Mori R, Hori N, Shibuya K. Behavioral interventions to reduce the transmission of HIV infection among sex workers and their clients in high-income countries. The Cochrane database of systematic reviews. 2011(12):Cd006045.

49. Shahmanesh M, Patel V, Mabey D, Cowan F. Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sex workers in resource poor setting: a systematic review. Tropical medicine & international health: TM & IH. 2008;13(5):659–79.

50. Hong Y, Poon AN, Zhang C. HIV/STI prevention interventions targeting FSWs in China: a systematic literature review. AIDS care. 2011;23 Suppl 1:54–65. doi: 10.1080/09540121.2011.554526 21660751

51. Fogarty International Center. Implementation Science Information and Resources [cited 2014 November 20, 2014]. Available from: http://www.fic.nih.gov/ResearchTopics/Pages/ImplementationScience.aspx.

52. Tran NT, Bennett SC, Bishnu R, Singh S. Analyzing the sources and nature of influence: how the Avahan program used evidence to influence HIV/AIDS prevention policy in India. Implementation science: IS. 2013;8:44. doi: 10.1186/1748-5908-8-44 23594956

53. Laga M, Vuylsteke B. Evaluating AVAHAN's design, implementation and impact: lessons learned for the HIV Prevention Community. BMC public health. 2011;11 Suppl 6:S16. doi: 10.1186/1471-2458-11-S6-S16 22376320

54. Wheeler T, Kiran U, Dallabetta G, Jayaram M, Chandrasekaran P, Tangri A, et al. Learning about scale, measurement and community mobilisation: reflections on the implementation of the Avahan HIV/AIDS initiative in India. Journal of epidemiology and community health. 2012;66 Suppl 2:ii16–25. doi: 10.1136/jech-2012-201081 22945907

55. Bertozzi SM, Padian N, Martz TE. Evaluation of HIV prevention programmes: the case of Avahan. Sexually transmitted infections. 2010;86 Suppl 1:i4–5. doi: 10.1136/sti.2009.039263 20167729

56. Kerrigan D, Wirtz A, Baral S, N'Jie ND, Stanciole JA, Butler J, et al. The global HIV epidemics among sex workers: World Bank Publications; 2012.

57. amfAR. The Shifting Global Health Landscape:Implications for HIV/AIDS and Vulnerable Populations. 2010.

58. Sex Worker Health and Rights: Where is the Funding? Open Society Institute, 2006.

59. Gates Foundation’s India AIDS Initiative Announces the Release of its First Grants Worth $67.5 Million [press release]. 2003.

60. Wilson D, Donald B. Too soon for rich countries to stop HIV funding in poor ones 2014. Available from: http://theconversation.com/too-soon-for-rich-countries-to-stop-hiv-funding-in-poor-ones-28717.

61. UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2012. 2012.

62. Mishra S, Biradavolu MR, Tankasala N, George A, Blankenship KM (2015) No-one-size-fits-all: Mapping Multiple Approaches and Outcomes of Community Mobilization from Avahan's Scaled-up HIV Prevention Intervention. PLoS ONE. In press.

63. National AIDS and STIs Control Programme (NASCOP). National Guidelines for HIV/STI Services for Sex Workers. 2010.

64. Norris AH, Kitali AJ, Worby E. Alcohol and transactional sex: how risky is the mix? Social science & medicine. 2009;69(8):1167–76.

65. Leclerc-Madlala S. Transactional Sex and the Pursuit of Modernity 2004.

66. Aral SO, Ward H. Modern day influences on sexual behavior. Infectious disease clinics of North America. 2005;19(2):297–309. 15963873

67. National AIDS Control Program. HIV Second Generation Surveillance in Pakistan 2007. Round Two Report. 2007.

68. Buzdugan R, Copas A, Moses S, Blanchard J, Isac S, Ramesh BM, et al. Devising a female sex work typology using data from Karnataka, India. International journal of epidemiology. 2010;39(2):439–48. doi: 10.1093/ije/dyp351 19995861

69. Buzdugan R, Halli SS, Cowan FM. The female sex work typology in India in the context of HIV/AIDS. Tropical medicine & international health: TM & IH. 2009;14(6):673–87.

70. Patrick K, Griswold WG, Raab F, Intille SS. Health and the mobile phone. American journal of preventive medicine. 2008;35(2):177–81. doi: 10.1016/j.amepre.2008.05.001 18550322

71. Mahapatra B, Saggurt N, Halli S, Jain A. HIV Risk Behaviors among Female Sex Workers Using Cell Phone. Journal of AIDS & Clinical Research. 2012;S1(014).

72. Global Fund. Global Fund Information Note: Addressing Sex Work, MSM and Transgender People in the Context of the HIV Epidemic. 2014.

73. amfAR. MSM, HIV, and the Road to Universal Access—How Far Have We Come? Special Report. 2008.

74. UNAIDS. UNAIDS Action Framework: Universal Access for Men who have Sex with Men and Transgender People. 2009.

75. UNAIDS. UNAIDS Guidance note on HIV and sex work: Key programmes to reduce stigma and discrimination and increase access to justice in national HIV responses. 2012.

76. Fay H, Baral SD, Trapence G, Motimedi F, Umar E, Iipinge S, et al. Stigma, health care access, and HIV knowledge among men who have sex with men in Malawi, Namibia, and Botswana. AIDS and behavior. 2011;15(6):1088–97. doi: 10.1007/s10461-010-9861-2 21153432

77. IGLHRC. Off the Map:How HIV/AIDS programming is failing same sex practicing people in Africa. 2007.

78. UNAIDS. The GAP Report. 2014.

79. Kelly JA, Murphy DA, Bahr GR, Koob JJ, Morgan MG, Kalichman SC, et al. Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection. Health psychology: official journal of the Division of Health Psychology, American Psychological Association. 1993;12(3):215–9.

80. Rekart ML. Sex-work harm reduction. Lancet. 2005;366(9503):2123–34. 16360791

81. Beattie TS, Bhattacharjee P, Suresh M, Isac S, Ramesh BM, Moses S. Personal, interpersonal and structural challenges to accessing HIV testing, treatment and care services among female sex workers, men who have sex with men and transgenders in Karnataka state, South India. Journal of epidemiology and community health. 2012;66 Suppl 2:ii42–8. doi: 10.1136/jech-2011-200475 22495772

82. Mtetwa S, Busza J, Chidiya S, Mungofa S, Cowan F. "You are wasting our drugs": health service barriers to HIV treatment for sex workers in Zimbabwe. BMC public health. 2013;13:698. doi: 10.1186/1471-2458-13-698 23898942

83. Scambler G, Paoli F. Health work, female sex workers and HIV/AIDS: global and local dimensions of stigma and deviance as barriers to effective interventions. Social science & medicine. 2008;66(8):1848–62.

84. Scorgie F, Nakato D, Harper E, Richter M, Maseko S, Nare P, et al. 'We are despised in the hospitals': sex workers' experiences of accessing health care in four African countries. Culture, health & sexuality. 2013;15(4):450–65.

Štítky
Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine


2015 Číslo 6
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Eozinofilní granulomatóza s polyangiitidou
nový kurz
Autori: doc. MUDr. Martina Doubková, Ph.D.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#