Strengthening HIV prevention programmes that target sex workers

8 September 2015

Sex work is defined by the Global Network of Sex Work Projects and UNAIDS as the exchange of sexual gratification for gifts or favours.  These can range from cash to goods, promotion, rent, food, clothes, hair-does, car or taxi rides, party invites, vacations or just profiling with a person or group of persons. 

Since the beginning of the HIV epidemic more than 30 years ago, sex workers have been among the vulnerable and most affected populations.  Sex work is also one of the primary drivers of HIV in the region.  Recent data from UNAIDS shows the prevalence rate among female sex workers in the Caribbean ranges from 5% in Jamaica to 7% in Suriname, 8.4% in Haiti and 17% in Guyana. This compares adversely with the Caribbean prevalence rate of approximately 1% in the general population. 

Sex workers are so affected by HIV for reasons that include the number of sexual partners, unsafe working conditions, and barriers to the negotiation of consistent condom use, and unequal access to health and other social services. Stigma and discrimination and laws that criminalize sex work often force the sex worker population to remain underground. Some fear the possibility of breach of confidentiality, verbal and physical abuse, and public humiliation and so avoid going into health establishments to seek advice and treatment for sexually transmitted infections. This in turn increases their risk of contracting HIV.

In its role as co-convener of HIV and sex work under UNAIDS division of labour for co-sponsoring agencies, UNFPA implements diverse activities in the response to HIV and sex work.  Recently, UNFPA in collaboration with partners facilitated a workshop in Trinidad and Tobago to build the capacity of key personnel within National AIDS Programmes and Civil Society Organizations in the use of the Sex Worker Implementation Tool (SWIT).  The tool offers practical advice on implementation of HIV and STI programmes for sex workers. It contains examples of good practices from around the world that may support efforts in planning programmes and services, and describes issues that should be considered and how to overcome challenges.

Topics covered in the tool include approaches and principles to building comprehensive sex work programmes, community empowerment; violence against sex workers; community-led services; condom programming and programme management

Participants in the workshop organized by UNFPA in association with UNAIDS, Pan Caribbean Partnership on HIV/AIDS (PANCAP), Caribbean Vulnerable Coalition (CVC) and the Caribbean Sex Workers Coalition (CSWC) came from seven countries in the region. They include Anguilla, Barbados, Belize, Grenada, Guyana, Jamaica, Suriname Trinidad and Tobago.

UNFPA as part of the Joint United Nations Programme on HIV works closely with global and national partners towards reducing risk and vulnerabilities to end the AIDS epidemic