HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs

There is evidence that hiv prevention programs for sex workers,especially female sex workers,are cost-effective in several contexts,including many western countries,thailand,india,the democratic republic of congo,kenya,and zimbabwe. the evidence that sex worker hiv prevention programs work must not inspire complacency but rather a renewed effort to expand,intensify,and maximize their impact. the plos collection “focus on delivery and scale: achieving hiv impact with sex workers” highlights major challenges to scaling-up sex worker hiv prevention programs,noting the following: sex worker hiv prevention programs are insufficiently guided by understanding of epidemic transmission dynamics,situation analyses,and programmatic mapping; sex worker hiv and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker hiv prevention programs are inadequately codified to ensure consistency and quality; and many sex worker hiv prevention programs have not evolved adequately to address informal sex workers,male and transgender sex workers,and mobile- and internet-based sex workers. based on the wider collection of papers,this article presents three major clusters of recommendations: (i) hiv programs focused on sex workers should be prioritized,developed,and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker hiv prevention programs in low and middle income countries; and (iii) comprehensive,integrated,and rapidly evolving hiv programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work. © 2015 david wilson.