1. Operational Approaches for Comprehensive Sex Worker Programmes An overview of Implementing Comprehensive HIV/STI Programmes with Sex Workers: Practical Approaches from Collaborative Interventions

2. 2012 Recommendations Good practice recommendations 1.Decriminalization of sex work. 2.Antidiscrimination and other rights-respecting laws. 3.Available, accessible and acceptable health services for sex workers. 4.Prevent and address violence against sex workers. Evidence-based recommendations 1.Enhance community empowerment. 2.Promote correct and consistent condom use (among sex workers and their clients). 3.Offer periodic screening for asymptomatic STIs to female sex workers. 4.Offer periodic presumptive treatment for asymptomatic STIs to female sex workers (as an emergency response in settings with high prevalence and limited clinical services). 5.Offer voluntary HIV testing and counselling. 6.Offer antiretroviral therapy (ART) for HIV-positive sex workers. 7.Offer harm reduction interventions for sex workers who inject drugs (especially NSP and OST). 8.Offer catch-up hepatitis B immunization. Background

3. 1.Developed in response to requests from practitioners for practical information on how to implement the 2012 recommendations. 2.Designed for public-health officials, managers of HIV and STI programmes, NGOs, community and civil-society organizations, health workers. 3.Written and reviewed by sex workers, service providers, researchers, government officials and NGOs, including WHO, UNFPA, UNAIDS, NSWP. This Sex Worker Implementation Tool was….

4. The Tool….. ….has six chapters and provides….. Detailed description of interventions and approaches by and with sex workers Case examples from around the world Ideas for addressing challenges in implementation Lists of practical resources available online

5. Chapter Community Empowerment A process in which sex workers: Take individual and collective ownership of programmes in order to achieve the most effective HIV responses Take concrete action to address social and structural barriers to their broader health and human rights Progress from programmes done for them → programmes done with them → programmes led by them 1

6. Chapter Community Empowerment 1 Key elements of community empowerment among sex workers

7. Chapter Addressing Violence against Sex Workers Describes and defines: Forms of violence Dynamics of violence Legal and policy issues Core programming values Core programming principles 2

8. Details promising interventions: Community empowerment Training and sensitizing sex workers about sex work-related laws and their human rights Advocating for legal and policy reforms Fostering police accountability Promoting the safety and security of sex workers Providing health services to sex workers who experience violence Providing psychosocial, legal and other support services Chapter Addressing Violence against Sex Workers Provides practical examples and suggestions

9. Chapter Community-led Services 3 Describes how to design and implement three types of community-led services

10. Chapter Community-led Services 3 Provides many practical examples and suggestions

11. Chapter Condom and Lubricant Programming Provides practical details for three steps of effective programming: 1.Establishing accessible supplies 2.Multi-level promotion 3.Creating an enabling environment 4

12. Chapter Condom and Lubricant Programming 4 1. Establishing accessible supplies Forecasting Procurement Quality assurance Warehousing and storage Distribution, logistics management 2. Multi-level promotion Community-led condom promotion De-stigmatizing condoms in the broader environment 3. Creating an enabling environment Supportive policy, legal and regulatory frameworks National policies Local strategies

13. Chapter Clinical and Support Services Discusses how to implement the recommended package of services for sex workers: Voluntary HIV testing and counselling Antiretroviral therapy Treatment for tuberculosis Harm reduction services for sex workers who inject drugs (needle & syringe programmes, opioid substitution therapy) Sexually transmitted infections Sexual and reproductive health Mental health 5

14. Chapter Clinical and Support Services Highlights key operational principles: Voluntary, with informed consent Confidential Appropriate Accessible Acceptable Affordable 5 Emphasises service delivery and integration: Co-location of services Training providers in multiple areas Links to other service providers

15. Chapter Part I: Programme Management Design Define programme and standards Establish a data monitoring system for management Plan the programme evaluation Organize Define the management structure Imple- ment Prioritize Implement in a staged manner Establish a supervision system Progressively ensure full sex worker participation 6 Describes an approach to scaled programming with sex workers

16. Chapter Part II: Organizational Capacity-Building 6 Describes approaches to: Forming a registered organization Governance Project management Resource mobilization Networking

17. Available at: http://www.who.int/hiv/pub/sti/se x_worker_implementation/en/ Anastacia Ryan (anastacia.ryan@outlook.com)