What Works for Women and Girls

tion committee with high government support, an outreach team, VCT sites, a needleexchange center, a methadone maintenance clinic, STI clinics, support groups, trainedpeer educators and social marketing of condoms. More than 150 sex workers wereinterviewed in each community in 2003, 2004, and 2005. By 2005, sex workers in theintervention community were seven times more likely to have appropriate responsesfor questions on HIV, more sex workers in the intervention community perceivedthemselves at risk for acquiring HIV and at least twice as likely to report condom usewith clients and sex worker partners. HIV knowledge was significantly associated withcondom use. While over 75% sex workers in the intervention community reportedaccessing VCT, less than 10% of sex workers from the community with no interventionreported accessing VCT (Lau et al., 2007a). (Gray III) (sex workers, condom use, HIVtesting, China)An HIV prevention program developed a training program to enhance self-esteem,communication and leadership among sex workers in Karnakata, south India. Followingthe intervention, STI service utilization increased from 75 clinic visits per month in2005 to over 900 clinic visits in 2007 (Lakkappa et al., 2008). (Abstract) (sex workers,STIs, India)A project with 700 female sex workers and MSM in India where beneficiaries suchas sex workers manage all HIV program interventions—outreach, condom promotionand linkages with government health services resulted in 20% increase in condom use(Varada and Selva, 2008). (Abstract) (sex workers, MSM, condom use, India)2. Clinic-based interventions with outreach workers can be effective in increasing condomuse among sex workers.A study of 924 female sex workers from 2004 to 2008 in Mexico’s border cities foundthat one 30-minute intervention based on principles of behavior change led to anincrease in protected sex acts and a 40% decrease in STIs over a six month periodwhen compared to a group that received standard presentation of prevention messagesfor VCT. Local health workers in the intervention group discussed with women how tonegotiate safer sex, barriers to using protection, negotiation of condom use and waysto improve social support (Patterson et al., 2008). (Gray III) (sex workers, communityoutreach, sex behavior, condom use, HIV testing, STIs, Mexico)A prospective, community-based, pre/post, intervention trial set in entertainmentestablishments (karaoke bars, massage parlors, dance halls, beauty parlors) where sexworkers operate at sites in five provinces of China (Anhui, Beijing, Fujian, Guangxi andXinjiang) showed increased condom use and decreased STI prevalence after setting upa Women’s Health Clinic near participants’ places of work at each site. The participantswere all sex workers working in targeted entertainment establishments. Clinic-basedoutreach activities, including awareness-raising, condom promotion, and sexual healthcare, were developed and delivered to sex workers. Cross-sectional surveys at baseline82 CHAPTER 4 PREVENTION FOR KEY AFFECTED POPULATIONS