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Implementing comprehensive HIV/STI programmes with sex workers: practical approaches from collaborative interventions

Published by: WHO


About

This tool offers practical advice on implementing HIV and STI programmes for and with sex workers. It is based on the recommendations in the guidance document on Prevention and treatment of HIV and other sexually transmitted infections for sex workers in low- and middle-income countries published in 2012 by the World Health Organization, the United Nations Population Fund, the Joint United Nations Programme on HIV/AIDS and the Global Network of Sex Work Projects. Topics covered in the tool 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; they include how to implement the recommended condom and lubricant programming, and other crucial health-care interventions for HIV prevention, treatment and care; and they include suggestions on how to manage programmes and build the capacity of sex worker organizations. The tool contains examples of good practice from around the world that may support efforts in planning programmes and services. The tool is designed for use by public-health officials and managers of HIV and STI programmes; NGOs, including community and civil-society organizations; and health workers. It may also be of interest to international funding agencies, health policy-makers and advocates.

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General Information

SDGs Goal 3: Good health and well-being Goal 16: Peace, justice and strong institutions
Published
2013
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Ensure healthy lives and promote well-being for all

Since the creation of the Millennium Development Goals there have been historic achievements in reducing child mortality, improving maternal health and tackling HIV/AIDS, tuberculosis, malaria and other diseases. In 15 years, the number of people newly infected by HIV each year has dropped from 3.1 million to 2 million and over 6.2 million lives were saved from malaria. Since 1990, maternal mortality fell by 45 percent, and worldwide there has been an over 50 percent decline in preventable child deaths globally.  

Despite this incredible progress, AIDS is the leading cause of death among adolescents in sub-Saharan Africa, and 22 million people living with HIV are not accessing life-saving antiretroviral therapy. New HIV infections continue to rise in some locations and in populations that are typically excluded or marginalised.

Chronic and catastrophic disease remains one of the main factors that push households from poverty into deprivation. Non-communicable diseases (NCDs) impose a large burden on human health worldwide. Currently, 63% of all deaths worldwide stem from NCDs – chiefly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. The cumulative economic losses to low- and middle-income countries from the four diseases are estimated to surpass US$ 7 trillion by 2025. Additionally, there continues to be underinvestment in the social circumstances and environmental factors affecting health. The job on HIV and health is far from done.

Recognizing the interdependence of health and development, the Sustainable Development Goals (SDGs) provide an ambitious, comprehensive plan of action for people, planet and prosperity and for ending the injustices that underpin poor health and development outcomes.

SDG 3 aspires to ensure health and well-being for all, including a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030. It also aims to achieve universal health coverage, and provide access to safe and effective medicines and vaccines for all. Supporting research and development for vaccines is an essential part of this process as well as expanding access to affordable medicines.

Promoting health and well-being is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 3.

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Ensure healthy lives and promote well-being for all

Since the creation of the Millennium Development Goals there have been historic achievements in reducing child mortality, improving maternal health and tackling HIV/AIDS, tuberculosis, malaria and other diseases. In 15 years, the number of people newly infected by HIV each year has dropped from 3.1 million to 2 million and over 6.2 million lives were saved from malaria. Since 1990, maternal mortality fell by 45 percent, and worldwide there has been an over 50 percent decline in preventable child deaths globally.  

Despite this incredible progress, AIDS is the leading cause of death among adolescents in sub-Saharan Africa, and 22 million people living with HIV are not accessing life-saving antiretroviral therapy. New HIV infections continue to rise in some locations and in populations that are typically excluded or marginalised.

Chronic and catastrophic disease remains one of the main factors that push households from poverty into deprivation. Non-communicable diseases (NCDs) impose a large burden on human health worldwide. Currently, 63% of all deaths worldwide stem from NCDs – chiefly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. The cumulative economic losses to low- and middle-income countries from the four diseases are estimated to surpass US$ 7 trillion by 2025. Additionally, there continues to be underinvestment in the social circumstances and environmental factors affecting health. The job on HIV and health is far from done.

Recognizing the interdependence of health and development, the Sustainable Development Goals (SDGs) provide an ambitious, comprehensive plan of action for people, planet and prosperity and for ending the injustices that underpin poor health and development outcomes.

SDG 3 aspires to ensure health and well-being for all, including a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030. It also aims to achieve universal health coverage, and provide access to safe and effective medicines and vaccines for all. Supporting research and development for vaccines is an essential part of this process as well as expanding access to affordable medicines.

Promoting health and well-being is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 3.

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The SDG Fund response

By incorporating health services and health specialists, the SDG Fund programmes tackle the health challenges and opportunities underlying intersectoral interventions. In addition, the SDG Fund, particularly through the work of the World Health Organization, promotes positive changes in national and local health policies.

For example,

  • In Guatemala, the SDG Fund programme is addressing the health damages produced by aflatoxin contamination in corn. A risk analysis report is determining the prevalence and damage to health and a pilot is being tested to be expanded to other regions in the country.
  • In Paraguay, the SDG Fund is working with the health system as part of a cross-sector approach for indigenous and vulnerable rural households, particularly female headed families, to produce nutritious and diversified food production. Health personnel is being trained on new monitoring systems to track health and nutrition status.
  • In Sri Lanka, the joint programme is addressing food insecurity by closely aligning with national policies and using national surveys for more efficient and effective investments in food security and nutrition by highlighting the gaps, opportunities and impact of current initiatives. For example, the Demographic and Health Survey (DHS) includes a detailed assessment of nutrition for children under 5 and a manual on health and nutrition for preschool is being developed to improve nutrition in schools.
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The SDG Fund response

By incorporating health services and health specialists, the SDG Fund programmes tackle the health challenges and opportunities underlying intersectoral interventions. In addition, the SDG Fund, particularly through the work of the World Health Organization, promotes positive changes in national and local health policies.

For example,

  • In Guatemala, the SDG Fund programme is addressing the health damages produced by aflatoxin contamination in corn. A risk analysis report is determining the prevalence and damage to health and a pilot is being tested to be expanded to other regions in the country.
  • In Paraguay, the SDG Fund is working with the health system as part of a cross-sector approach for indigenous and vulnerable rural households, particularly female headed families, to produce nutritious and diversified food production. Health personnel is being trained on new monitoring systems to track health and nutrition status.
  • In Sri Lanka, the joint programme is addressing food insecurity by closely aligning with national policies and using national surveys for more efficient and effective investments in food security and nutrition by highlighting the gaps, opportunities and impact of current initiatives. For example, the Demographic and Health Survey (DHS) includes a detailed assessment of nutrition for children under 5 and a manual on health and nutrition for preschool is being developed to improve nutrition in schools.
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  • By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
  • By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
  • By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
  • By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
  • Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
  • By 2020, halve the number of global deaths and injuries from road traffic accidents
  • By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
  • Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
  • By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
  • Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
  • Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
  • Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
  • Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
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  • By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
  • By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
  • By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
  • By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
  • Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
  • By 2020, halve the number of global deaths and injuries from road traffic accidents
  • By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
  • Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
  • By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
  • Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
  • Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
  • Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
  • Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
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Promote just, peaceful and inclusive societies

Peace, stability, human rights and effective governance based on the rule of law are important conduits for sustainable development. We are living in a world that is increasingly divided. Some regions enjoy sustained levels of peace, security and prosperity while others fall into seemingly endless cycles of conflict and violence. This is by no means inevitable and must be addressed.

High levels of armed violence and insecurity have a destructive impact on a country’s development, affecting economic growth and often resulting in long standing grievances among communities that can last for generations. Sexual violence, crime, exploitation and torture are also prevalent where there is conflict or no rule of law, and countries must take measures to protect those who are most at risk.

The Sustainable Development Goals (SDGs) aim to significantly reduce all forms of violence, and work with governments and communities to find lasting solutions to conflict and insecurity. Strengthening the rule of law and promoting human rights is key to this process, as is reducing the flow of illicit arms and strengthening the participation of developing countries in the institutions of global governance.

Promoting peace and justice is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 16.

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Promote just, peaceful and inclusive societies

Peace, stability, human rights and effective governance based on the rule of law are important conduits for sustainable development. We are living in a world that is increasingly divided. Some regions enjoy sustained levels of peace, security and prosperity while others fall into seemingly endless cycles of conflict and violence. This is by no means inevitable and must be addressed.

High levels of armed violence and insecurity have a destructive impact on a country’s development, affecting economic growth and often resulting in long standing grievances among communities that can last for generations. Sexual violence, crime, exploitation and torture are also prevalent where there is conflict or no rule of law, and countries must take measures to protect those who are most at risk.

The Sustainable Development Goals (SDGs) aim to significantly reduce all forms of violence, and work with governments and communities to find lasting solutions to conflict and insecurity. Strengthening the rule of law and promoting human rights is key to this process, as is reducing the flow of illicit arms and strengthening the participation of developing countries in the institutions of global governance.

Promoting peace and justice is one of 17 Global Goals that make up the 2030 Agenda for Sustainable Development. An integrated approach is crucial for progress across the multiple goals.

Learn more about the targets for Goal 16.

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The SDG Fund response

The 2030 Agenda requires a greater involvement among governments, civil society, private sector and international organizations to build more peaceful and inclusive just societies. Peace also brings new business opportunities by increasing stability, improving economic prospects and by building social and economic fabric in a community.

For example,

  • The armed conflict in Colombia has damaged production, institutions, food security, and social trust. Through the sustainable agricultural production of indigenous crops and their international commercialization, the SDG-F will create employment, better nutrition, and, most importantly, peace in Cauca - one of the zones most affected by the long lasting conflict.
  • In Sierra Leone, the SDG Fund is working for improved accountability and transparency in natural resource governance. This will contribute to promoting peace in the mining communities of the project and help to generate income that will be reinvested in the development of the communities.
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The SDG Fund response

The 2030 Agenda requires a greater involvement among governments, civil society, private sector and international organizations to build more peaceful and inclusive just societies. Peace also brings new business opportunities by increasing stability, improving economic prospects and by building social and economic fabric in a community.

For example,

  • The armed conflict in Colombia has damaged production, institutions, food security, and social trust. Through the sustainable agricultural production of indigenous crops and their international commercialization, the SDG-F will create employment, better nutrition, and, most importantly, peace in Cauca - one of the zones most affected by the long lasting conflict.
  • In Sierra Leone, the SDG Fund is working for improved accountability and transparency in natural resource governance. This will contribute to promoting peace in the mining communities of the project and help to generate income that will be reinvested in the development of the communities.
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  • Significantly reduce all forms of violence and related death rates everywhere
  • End abuse, exploitation, trafficking and all forms of violence against and torture of children
  • Promote the rule of law at the national and international levels and ensure equal access to justice for all
  • By 2030, significantly reduce illicit financial and arms flows, strengthen the recovery and return of stolen assets and combat all forms of organized crime
  • Substantially reduce corruption and bribery in all their forms
  • Develop effective, accountable and transparent institutions at all levels
  • Ensure responsive, inclusive, participatory and representative decision-making at all levels
  • Broaden and strengthen the participation of developing countries in the institutions of global governance
  • By 2030, provide legal identity for all, including birth registration
  • Ensure public access to information and protect fundamental freedoms, in accordance with national legislation and international agreements
  • Strengthen relevant national institutions, including through international cooperation, for building capacity at all levels, in particular in developing countries, to prevent violence and combat terrorism and crime
  • Promote and enforce non-discriminatory laws and policies for sustainable development
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  • Significantly reduce all forms of violence and related death rates everywhere
  • End abuse, exploitation, trafficking and all forms of violence against and torture of children
  • Promote the rule of law at the national and international levels and ensure equal access to justice for all
  • By 2030, significantly reduce illicit financial and arms flows, strengthen the recovery and return of stolen assets and combat all forms of organized crime
  • Substantially reduce corruption and bribery in all their forms
  • Develop effective, accountable and transparent institutions at all levels
  • Ensure responsive, inclusive, participatory and representative decision-making at all levels
  • Broaden and strengthen the participation of developing countries in the institutions of global governance
  • By 2030, provide legal identity for all, including birth registration
  • Ensure public access to information and protect fundamental freedoms, in accordance with national legislation and international agreements
  • Strengthen relevant national institutions, including through international cooperation, for building capacity at all levels, in particular in developing countries, to prevent violence and combat terrorism and crime
  • Promote and enforce non-discriminatory laws and policies for sustainable development
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It is based on the recommendations in the guidance document on Prevention and treatment of HIV and other sexually transmitted infections for sex workers in low- and middle-income countries published in 2012 by the World Health Organization, the United Nations Population Fund, the Joint United Nations Programme on HIV/AIDS and the Global Network of Sex Work Projects. Topics covered in the tool 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; they include how to implement the recommended condom and lubricant programming, and other crucial health-care interventions for HIV prevention, treatment and care; and they include suggestions on how to manage programmes and build the capacity of sex worker organizations. The tool contains examples of good practice from around the world that may support efforts in planning programmes and services. The tool is designed for use by public-health officials and managers of HIV and STI programmes; NGOs, including community and civil-society organizations; and health workers. It may also be of interest to international funding agencies, health policy-makers and advocates. [format] => [safe_value] => This tool offers practical advice on implementing HIV and STI programmes for and with sex workers. It is based on the recommendations in the guidance document on Prevention and treatment of HIV and other sexually transmitted infections for sex workers in low- and middle-income countries published in 2012 by the World Health Organization, the United Nations Population Fund, the Joint United Nations Programme on HIV/AIDS and the Global Network of Sex Work Projects. Topics covered in the tool 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; they include how to implement the recommended condom and lubricant programming, and other crucial health-care interventions for HIV prevention, treatment and care; and they include suggestions on how to manage programmes and build the capacity of sex worker organizations. The tool contains examples of good practice from around the world that may support efforts in planning programmes and services. The tool is designed for use by public-health officials and managers of HIV and STI programmes; NGOs, including community and civil-society organizations; and health workers. It may also be of interest to international funding agencies, health policy-makers and advocates. ) ) ) [field_year] => Array ( [und] => Array ( [0] => Array ( [value] => 2013-01-01 00:00:00 [timezone] => America/New_York [timezone_db] => America/New_York [date_type] => datetime ) ) ) [field_publication_keywords] => Array ( ) [field_publisher] => Array ( [und] => Array ( [0] => Array ( [value] => WHO [format] => [safe_value] => WHO ) ) ) [field_region] => Array ( ) [field_thumb] => Array ( [und] => Array ( [0] => Array ( [fid] => 1558 [uid] => 1 [filename] => SWIT_en_UNDP-logo_0-1.jpg [uri] => public://SWIT_en_UNDP-logo_0-1.jpg [filemime] => image/jpeg [filesize] => 116910 [status] => 1 [timestamp] => 1485787792 [type] => image [field_file_image_alt_text] => Array ( ) [field_file_image_title_text] => Array ( ) [rdf_mapping] => Array ( ) [metadata] => Array ( [height] => 841 [width] => 595 ) [alt] => [title] => [height] => 841 [width] => 595 ) ) ) [field_featured] => Array ( ) [field_file_fr] => Array ( ) [field_file_ar] => Array ( ) [field_file_pt] => Array ( ) [field_file_es] => Array ( ) [field_external_link] => Array ( [und] => Array ( [0] => Array ( [value] => http://www.unfpa.org/sites/default/files/pub-pdf/SWIT_en_UNDP%20logo_0.pdf [format] => [safe_value] => http://www.unfpa.org/sites/default/files/pub-pdf/SWIT_en_UNDP%20logo_0.pdf ) ) ) [field_external_link_text] => Array ( [und] => Array ( [0] => Array ( [value] => External Link [format] => [safe_value] => External Link ) ) ) [rdf_mapping] => Array ( [rdftype] => Array ( [0] => sioc:Item [1] => foaf:Document ) [title] => Array ( [predicates] => Array ( [0] => dc:title ) ) [created] => Array ( [predicates] => Array ( [0] => dc:date [1] => dc:created ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [changed] => Array ( [predicates] => Array ( [0] => dc:modified ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) [body] => Array ( [predicates] => Array ( [0] => content:encoded ) ) [uid] => Array ( [predicates] => Array ( [0] => sioc:has_creator ) [type] => rel ) [name] => Array ( [predicates] => Array ( [0] => foaf:name ) ) [comment_count] => Array ( [predicates] => Array ( [0] => sioc:num_replies ) [datatype] => xsd:integer ) [last_activity] => Array ( [predicates] => Array ( [0] => sioc:last_activity_date ) [datatype] => xsd:dateTime [callback] => date_iso8601 ) ) [cid] => 0 [last_comment_timestamp] => 1482444551 [last_comment_name] => [last_comment_uid] => 1990 [comment_count] => 0 [name] => Library Manager 1 [picture] => 0 [data] => a:1:{s:7:"contact";i:0;} [entity_view_prepared] => 1 ) [#items] => Array ( [0] => Array ( [value] => http://www.unfpa.org/sites/default/files/pub-pdf/SWIT_en_UNDP%20logo_0.pdf [format] => [safe_value] => http://www.unfpa.org/sites/default/files/pub-pdf/SWIT_en_UNDP%20logo_0.pdf ) ) [#formatter] => text_plain [0] => Array ( [#markup] => http://www.unfpa.org/sites/default/files/pub-pdf/SWIT_en_UNDP%20logo_0.pdf ) [#description] => Please enter the full URL, e.g. http://www.example.com [#printed] => 1 )