What Works for Women and Girls

ongoing after the study (Ngugi et al., 2007). (Gray V) (sex workers, condom use, counseling,community outreach, STIs, HIV testing, Kenya)An onsite clinic to provide sex workers with quality of care at a brothel in Johannesburg,South Africa found that condom use may have increased. Qualitative interviews showedthat information sessions by nurses positively affected condom use. Through nursecounseling, sex workers understood: “Even if he promises you more money [this]cannot buy your life” (p. 461). Data were drawn from 12 focus groups and ten in-depthinterviews with sex workers. Prior to the establishment of the on-site clinic, most sexworkers reported not using public health services due to abusive provider attitudes tosex workers, lack of appropriate drugs and long lines. The onsite clinic provided treatmentfor STIs, education and condoms. Over a 15-month period, 1,243 women werescreened and treated at least once for STIs. Sex workers incurred no travel costs toaccess the clinic. Sex workers reported that the clinic staff created an atmosphere ofhonesty and respectful treatment: “Everything is done through agreement…everythingis explained” (p. 460). (Stadler and Delany, 2006). (Gray V) (condom use, sex workers,STIs, South Africa)5. Peer education can increase condom use and HIV testing.A meta-analysis of 34 articles, 16 from Sub-Saharan Africa, 16 from East and CentralAsia and 2 from Latin America, of which 12 studies focused on sex workers, found thatpeer education was significantly associated with increased condom use (Medley et al.,2008b; Medley et al., 2009). (Gray I) (sex workers, peer education, condom use, Africa, EastAsia, Central Asia, Latin America)Peer education in Nigeria by sex workers resulted in increased condom use from 76.6%at baseline to 87.6% in 2004. Follow-up two years later in 2006 found condom use stillat 86.4% (Ankomah et al., 2008). (Abstract) (peer education, sex workers, condom use,Nigeria)A peer outreach program for sex workers in Myanmar, along with drop-in centersand clinics, resulted in 4,000 sex workers accessing VCT (Win and Rahman, 2008).(Abstract) (peer education, sex workers, counseling, HIV testing, Myanmar)6. Interventions targeting male clients can increase condom use and thus reduce HIV risk forsex workers.A study in Senegal found that a peer-mediated education and condom distributionprogram targeting male clients of sex workers was successful in increasing AIDSrelatedknowledge and consistent condom use. Twenty transport workers were electedby co-workers to attend a two-day training seminar to acquire general information onHIV/AIDS/STIs that included topics of transmission, symptoms, and preventativemeasures as well as condom negotiation and peer communication techniques. At theend of training peer educators were expected to provide basic HIV/AIDS information86 CHAPTER 4 PREVENTION FOR KEY AFFECTED POPULATIONS