1. Cheryl Overs Senior Programme Officer, Focused Prevention International HIV/AIDS Alliance Innovative Approaches to HIV Prevention in Commercial Sex

2. 2 Role of Commercial Sex in HIV Epidemics the right policy and programming can reduce HIV transmission during commercial sex dramatically prevention in commercial sex averts more secondary cases leading to a significant impact on the broader dynamics of the epidemic

3. 3 Sex Workers: from Grim Reaper to Agent of Change 1980s:risk groups 1990s:a backlash 2000+:new focus

4. 4 A new paradigm

5. 5 Three Strategies individual / cognitive participation / empowerment enabling environment

6. 6 Participation and Empowerment Social Capital: the ability to secure benefits through membership in networks and other social structures

7. 7 Social Inclusion maintaining contact with families access to resources - (primary) health care - documentation - housing - children’s schooling - financial management self-esteem civil rights culture

8. 8 Creating an Enabling Environment

9. 9 Opportunities for Solidarity wherever working conditions have been improved solidarity among workers has been a factor. mutual support and efficient use of limited resources advocacy and political action- many voices are stronger than one

10. 10 Solidarity in action

11. 11 Successful Policy and Programming Many interventions produce ………. *increased condom use *reduced STIs Some have produced …….. increased literacy increased safe sex practices decreased dependence on sex work increased financial autonomy among sex workers reduced child & forced prostitution reduced injecting/needle sharing reduced HIV transmission

12. 12 Controversial Policy and Programming

13. 13 Some Challenges mobile and migrant sex workers. drug users male and transgender sex workers refreshing the messages informal sex work income generation and exiting strategies linking prevention and care safe sex skills

14. 14 Care Today IS Prevention Tomorrow care settings are an opportunity to provide access to condoms and other resources information on rights, services and support reduced viral load and improved general health leads to reduced transmission BUT by threatening access to care, stigma and discrimination undermine prevention.

15. 15 Repackaging Safety and Pleasure

16. 16 International HIV/AIDS Alliance Queensberry House 104-106 Queens Road Brighton BN1 3XF Tel: +44 1273 718 900 Fax:+44 1273 718 901 www.aidsalliance.org www.aidsmap.com