What Works for Women and Girls

6. Women’s clubs along with peer education and condom distribution can reduce HIV prevalenceamong women who are sexual partners of male IDUs.In Vietnam, cross sectional surveys of 33 sexual partners of IDUs at baseline and 24months later found that women’s clubs, peer education and condom distributionincreased condom use and no surveyed female sexual partner of a male IDU becameHIV-positive. Condom use increased among seven female partners from 28% at baselineto 100% after 34 months, and among 26 sexual partners in a different district from29% at baseline to 46% after 24 months (Hammett et al., 2008). (Gray IV) (sexual partners,IDU, condom use, Vietnam)7. Nonjudgmental targeted counseling for IDUs can reduce HIV risk behaviors.A 2004 quantitative and qualitative study of NGO services by the Women Federationfor 226 male and female IDUs in China resulted in safer drug and sex practices. VCTservices that respected confidentiality were implemented by three male and three femalecounselors experienced in delivering health education to IDUs. Ten focus group discussionswere held with seven males and three females in each. Exit surveys found that63% of IDUs were ‘highly satisfied’ with VCT services and the remainder were ‘satisfied.”One IDU noted: “I was impressed that the Women Federation counselor did notdiscriminate against me and talked to me politely” (Chen et al., 2007c: 784). Sharingneedles was reduced from 45% to 33%; those who always used condoms with non-mainpartners increased from 7% to 24%. While at the start of the project, 82% never usedcondoms, this decreased to 35% (Chen et al., 2007). (Gray III) (counseling, IDU, condomuse, HIV testing, needles, China)8. Increased access to voluntary HIV counseling and testing to learn one’s serostatus mayreduce needle sharing and other HIV risk behaviors.A study from 2002–2004 evaluated the needle use and sexual practices of 266 injectingdrug users in Tallinn, Estonia found that those who knew they were HIV-positiveengaged in some protective behaviors. The participants had an average age of 25, were88% male, and had HIV tests. The study found that although 93% of participants knewthat HIV could be passed through shared needles and 98% knew that it could be spreadthrough unprotected sex, half of the participants had shared a needle in the last ninetydays and 26% had engaged in unprotected sex. However, those who knew that theywere HIV-positive were found to be significantly less likely to have given their needlesto others: 9% of HIV-positive participants who knew their status lent their needlesafter use, as compared to 25% of participants who were HIV-positive but did not knowtheir status. Knowledge of one’s HIV serostatus did not impact the likelihood of havingunprotected sex (Wilson et al., 2007). (Gray V) (IDU, sex behavior, needles, Estonia)98 CHAPTER 4 PREVENTION FOR KEY AFFECTED POPULATIONS