Publication Date
Publication Date: 
October 1, 2013

"Sex workers take charge of the community empowerment process by mobilizing with other sex workers to develop solutions to the issues they face as a group, and by advocating for their rights as sex workers and as human beings."

With community empowerment as the foundation, this tool offers practical advice on implementing HIV and sexually transmitted infection (STI) programmes for and with sex workers. It seeks to explain how to implement the recommendations in a guidance document on prevention and treatment of HIV and other STIs for sex workers in low- and middle-income countries, which was published in 2012 by the World Health Organization (WHO), the United Nations Population Fund (UNFPA), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the Global Network of Sex Work Projects (NSWP).

The 6 chapters contain examples of good practice from around the world that may support efforts in planning programmes and services, and describe issues that should be considered and how to overcome challenges. Topics covered include approaches and principles to building programmes that are led by the sex worker community such as community empowerment, addressing violence against sex workers, and community-led services. The resource explains how to implement the recommended condom and lubricant programming and other health-care interventions for prevention, treatment, and care of HIV and STIs, tuberculosis, viral hepatitis, and additional services such as for sexual and reproductive health, harm reduction for sex workers who inject drugs, post-rape care, and mental health. It also includes suggestions on how to manage programmes and build the capacity of sex worker organisations.

For example, chapter 1 defines community empowerment and explains why it is fundamental to addressing HIV and STIs among sex workers in an effective and sustainable way (Section 1.1). It then describes 8 elements of community empowerment, with examples from a number of programmes (Section 1.2). Here is one example: "In Kenya, frequent problems with law enforcement officers became an issue for collective action by sex workers. The Bar Hostess Empowerment and Support Programme (BHESP) developed a programme in Nairobi to train local sex workers as paralegals....They now educate other sex workers about their rights, help those who need legal advice and document human-rights violations, such as arbitrary arrest....The result is strong and empowered sex workers who know the law and the rights of sex workers and are able to mount straightforward challenges to arbitrary arrest and detention. Similar paralegal systems are being implemented by the Women's Legal Centre, which is funded by the Open Society Foundations in Cape Town, South Africa, among others. Such programmes addressing local needs and contexts build individual competencies and community resilience." The chapter also presents examples of indicators to measure the empowerment of sex worker organisations (Section 1.3) and a list of resources and further reading (Section 1.4).

Communication strategies related to provision of condoms are covered throughout the tool, such as community outreach workers supporting behaviour change (i.e., adopting and/or adhering to safer sex behaviours) by demonstrating, promoting, and distributing condoms and lubricants. The entirety of Chapter 4 focuses on condom and lubricant programming, covering issues such as destigmatisation in the broader social environment, social marketing, and condom negotiation strategies.

The tool is designed for use by: public health officials and managers of HIV and STI programmes; non-governmental organisations (NGOs), including community and civil society organisations; and health workers. It may also be of interest to international funding agencies, health policymakers, and advocates.

It is the product of a collaborative process including sex workers, service providers, researchers, government officials, NGOs from around the world, UN agencies, and development partners from the United States (US). These include the NSWP, WHO, UNAIDS, UNFPA, and the Bill & Melinda Gates Foundation.

Click here for the 196-page tool in PDF format.

Number of Pages: 



Emails from Gina Dallabetta and James Baer to The Communication Initiative on October 15 2013 and October 21 2013, respecively; and WHO website, October 21 2013.