What Works for Women and Girls

there were major socio-demographic changes observed in this population that may havecontributed to the decline of the diseases being monitored, “the increase in condom useand the decline in prevalence of HIV infection and other STDs may well have resultedfrom the prevention campaign for female sex workers, and such campaigns shouldtherefore be continued, strengthened, and expanded” (Ghys et al., 2002: 251). (Gray III)(sex workers, condoms, STIs, peer educators, social marketing, sexual partners, Côte d’Ivoire)The Sonagachi project in India which provided free access to STI treatment, condomsand peer education was successfully replicated, including community organizing andadvocacy; peer education; condom social marketing and establishment of a small clinic.Sex workers were randomly selected in 2 small urban communities in northeasternIndia. One hundred sex workers participated in each community, with an 85% retentionrate. Overall condom use increased significantly in the intervention communityto 39% as compared to 11% in the control community. The proportion of consistentcondom users increased 25% in the intervention community compared with a 16%decrease in the control community (Basu et al., 2004). (Gray III) Providers initiatedawareness and an offer of services at sex work sites through sex worker peer education,mobile VCT camps and community level task forces. Services include VCT; initiatingantiretroviral therapy with escorting to follow-up at government clinics; treatment foropportunistic infections and TB; nutritional support; and support for a network of positivewomen. VCT rates between 2004 and 2005 increased almost nine times to a totalof 2,578 with all who received counseling taking the HIV test. Barriers to HIV preventionand treatment were a belief that testing positive was a death sentence; lack of treatmentliteracy; and stigma by health provider (Saha, 2006). (Gray III) The communityempowerment model implemented in Sonagachi since 1992 has increased consistentcondom use to 85% and HIV prevalence among sex workers has remained stable below10%. Sonagachi has established high rates of partner notification through cohabitatingpartners acting as male peers for mobilizing clients for STI screening and promotionof safe sex; evening clinic hours for clients;. Partner treatment has increased from 40%in 2002 to 46% in 2007 at 13 STI clinics (Jana et al., 2008). (Abstract) Starting in 1992and with sex workers in control of the project since 1999, the project has grown from 12peer educator sex workers reaching 3,500 sex workers to 450 peer educators reaching45,000 sex workers. Condom use between 1999 and 2007 has increased from 2% to85% and HIV prevalence has stabilized at around 5% (Ray, 2008). (Abstract) (Gray IIIbased on Basu et al., 2004 and Saha, 2006) (sex workers, community organizing, condomuse, peer education, India)A study of two communities in China using data from behavioral surveillance in 2003,2004 and 2005 found that while baseline data in 2003 of the two communities was notsignificantly different, the county which had comprehensive HIV prevention interventionsfor female sex workers had significantly higher prevalence of condom use withclients and regular sex partners, higher HIV related knowledge and increased uptake ofVCT and HIV services by 2005. The HIV prevention intervention consisted of a preven-WHAT WORKS FOR WOMEN AND GIRLS81