HIV Risks Among Local & Traveling Female Commercial Sex Workers in the District DC-CFAR Research in Progress Seminar September 24 th, 2015 A Progress Report

Background  Migration and mobility are highly correlated with HIV/STIs among female commercial sex workers (FCSW) globally.  Little research on sex-work related mobility within the United States.  As a research location, Washington, DC hosts both a robust illicit sexual exchange economy and among the highest rates of HIV/STI in the country.  Additionally, we are interested in how vaginal biomarkers may also provide information about FCSW susceptibility or resilience to HIV/STI

Abbreviated Specific Aims  To determine the feasibility of using various sampling techniques including snowball (RDS), time-place, community leader (CPOL), and webRDS to recruit FCSWs.  To develop and pilot test a behavioral survey on the connection between occupational travel, access to health care, history of sexual victimization, community connectivity, and HIV/STI risks with FCSWs.  To develop and test the feasibility and acceptability of practices for collecting biological materials.

Research Plan Community Stakeholders and Service Provider Focus Groups (n=2) Female Sex Worker Focus Groups (n=4) One-on-One Interviews with Female Sex Workers (n=40)

Gaining Access

Obstacles  Receiving institutional review board (IRB) approval took considerable time (Started in March, obtained IRB for focus group in August).  HIPS and sex work community members have had concerns regarding some aspects of the research project.  Lessons learned.

Benefits  Provides STI/HIV testing opportunities to HIPS clients.  Potentially broadens HIPS client-base.  Informs and collect information on sex worker opinions and attitudes towards health services and research.  Tests the viability of several different types of participant recruitment (including web-based).  Establishes best practices around collecting biological data from FCSW.

Training  Every team member trained as a certified volunteer at HIPS: comprehensive training (30 hours, 3 full-days, five half-days) on harm-reduction and services to HIPS clients.  HIPS history, philosophy, and approach  Anti- Oppression  HIV/HCV and safe sex  Drug use, Syringes Exchange, and Safe injections  Sex work, violence, and self-care  Homelessness and linage to care  Crisis management and Hot-line training  Team building and simulation of outreach on a van

Field observations  HIPS equipment, data forms, and mission  DC sex work strolls and their characteristics  Drug-Associated Strolls  Identity-Associated Strolls  “High Track” Strolls  Types of FCSWs  TF and CIS FCSWs  Street walker follows weather, internet based follows money  Local vs. traveling FCSWs

Stakeholder Focus Group #1  Five Participants from HIPS, Women’s collectives, Network for Victim Recovery of DC (NVRDC), Sex Worker Rights (Baltimore).  Resources and gaps in services  Housing (couch surfing)  Mental Health (stress coping strategy- drug users)  Child support (failed relationship, child care)  Cultural competence and sensitized service from providers (hard to talk about sexual assault with doing sex work)  Empowerment/financial education  Opinions on Research Participation  Participate only if “I am convinced of the cause”, if I like the researchers  TF-neglected areas  Compensation  Logistics: safety, time of the day

Tasks and timeline Finish Stakeholder focus group #2: Early October Two focus groups with local FCSWs (Oct -Nov) Two Focus groups with traveling FCSWs ( Nov-Dec) Proposal for R21 (January) IRB for Interview and testing and preparations (December – March) 40 Interviews (April-August) RDS/ webRDS/targeted time-location Semi-structured Manuscripts (End of 2016)

Questions? Comments?  Primary Investigator: Jennifer Huang Bouey  Co-Investigator: Mimi Ghosh, Biomarkers & Biological Data  Project Manager: Katie Hail-Jares