What Works for Women and Girls

and post-intervention were used to evaluate changes in condom use with the last threeclients, and the prevalence of chlamydia and gonorrhea. In total, 907 sex workers weresurveyed at baseline and 782 at 12 months post-intervention. Outreach teams made 2552visits to the target entertainment establishments, approached 13,785 female sex workers,and distributed 33,575 copies of education material and 5102 packets of condoms. Therate of condom use with the most recent three clients increased from 55.2% at baselineto 67.5% at 12 months evaluation. The prevalence of gonorrhea fell from 26% at baselineto 4% after intervention, and that of chlamydia fell from about 41 to 26% (Rou etal., 2007). (Gray III) (sex workers, community outreach, condom use, STIs, China)In a prospective, community-based, pre/post-intervention trial of thirty establishmentsin Chengjiang, thirty-four in Ruili and twenty-three in Longchuan, China, outreachworkers visited the establishments to conduct intervention activities over six weeks. Thestudy participants were female sex workers. Intervention activities included lectures,discussion, video and audiocassettes, and distribution of educational folders andcondoms. Pre- and post-intervention cross-sectional surveys assessed changes in STI/AIDS knowledge and condom use. After the intervention, knowledge of the three HIVtransmission routes increased from 25 to 88%, knowledge that condoms can reduce therisk of STI/HIV infection increased from 56 to 94%. Condom use at last sex and in thelast three sexual encounters increased from 61 to 85% and from 41 to 70%, respectively.Multivariate analyses indicated that the intervention was an independent factor forthese changes. The intervention program was effective at increasing HIV/AIDS knowledgeand condom use rates among sex workers in the community (Wu et al., 2007b).(Gray III) (sex workers, community outreach, condoms, risk reduction, STIs, China)3. Policies that involve sex workers, brothel owners and clients in development and implementationof condom use can increase reported condom use. 1A pre- and post-test study that compared condom use and policies in 68 sex establishmentsin two cities in the Dominican Republic from 1999 to 2000 with 200 female sexworkers age 18 or older found that interventions that combined community solidaritywith government policy were the most effective in increasing condom use rates. Thestudy was approved by and involved the sex worker union of the Dominican Republic,MODEMU. The two environmental-structural interventions compared in the studyincluded a community-based approach implemented in sex establishments in one city,and a combined community-based approach with government policy and regulations inanother. Three interventions were implemented in both cities. First, a solidarity and1 Implementation of policies varies in practice. Recent documentation with 100% condom use policies, forexample in Cambodia (Lowe, 2002), suggest that some aspects of 100% condom use policies, such as mandatorySTI and HIV testing, can be disempowering to sex workers and violate human rights. Some have suggestedthat the Kerrigan 2004 and 2006 studies, along with the Pisey, 2008 study should not be instituted for thisreason.WHAT WORKS FOR WOMEN AND GIRLS83