Lessons and challenges for developing and delivering HIV programs for sex workers

Today sees the addition of an important paper to the PLOS Collection Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers; published in PLOS Medicine, David Wilson of World Bank looks at lessons learnt and challenges for developing and delivering HIV programs for sex workers.

The burden of HIV is heavily disproportionate in sex workers, where the high rates of partner change in their work and their vulnerability increase the likelihood of sexual transmitted infections. The Collection, writes Wilson, "challenges AIDS researchers and practitioners to initiate a new generation of comprehensive sex worker HIV prevention programs for a changing sex work context".

Other articles featured in the collection highlight the cost effectiveness of community mobilisation efforts in improving the uptake of services and influencing transmission of HIV and other STIs. Evidence shows the impact of HIV programmes with sex workers – such as those in Thailand and India – when they are implemented at a sufficient scale. Countries in Africa such as Benin, Burkino Faso and Nigeria have also executed effective and feasible interventions, but analysis of these show that funding in these programmes remains inadequate and, as a result, the large scale responses that are required do not exist.

With the increased burden of HIV infection, the rapid scale-up of combination prevention programmes and HIV care and treatment, in order to improve conditions for sex workers and the general population to contain the HIV epidemic on a global scale, is key.