Community development and HIV/STI-related vulnerability among female sex workers in Rio de Janeiro, Brazil

Abstract

The Sonagachi Project of Kolkata, India has been recognized as a model community development and human immunodeficiency virus/sexually transmitted infection (HIV/STI) prevention intervention among female sex workers. Limited research has been conducted regarding its applicability outside the South Asian context. This study sought to document the process and effectiveness of integrating community development activities based on the Sonagachi model into an ongoing HIV/STI peer education program with female sex workers in Rio de Janeiro, Brazil. Structured cross-sectional surveys examining HIV/STI-related behaviors and community development measures were conducted among approximately 500 sex workers at pre- and post-intervention. We found that several community development components including social cohesion and mutual aid were significantly associated with consistent condom use among sex workers and their paying clients at pre-intervention. However, only a minority of women actively engaged in community-building activities over the 18-month study period. In turn, limited changes in community development components and no significant increases in the HIV/STI-related protective behaviors assessed were documented. Findings indicate that internalized stigma and socioeconomic pressures may have constrained the scope and pace of community mobilization in this setting during the study observation period.

Fatores associados à violência contra mulheres profissionais do sexo de dez cidades brasileiras

“…More than half had suffered verbal abuse and more than one third physical abuse, both in the setting of their sex work -by clients and police -and in the domestic context, by intimate partners and family members or other known persons. These findings corroborate other studies such as Pando et al 16 and Kerrigan et al 11 , reporting that 25.9% of female sex workers in Rio de Janeiro suffered discrimination and 15.8% suffered violence related to sex work in the four months prior to the study. The current study's results demonstrate the disproportional burden of violence experienced by female sex workers in Brazil.…”

“…More than one-third walked the streets and had worked in the sex trade for three years or less. Kerrigan et al 11 observed a similar profile in another study of sex workers in Rio de Janeiro. The structural components of this profile, rooted in gender and class inequalities, reflect fundamental human rights violations and thus the high vulnerability of these women to violence, margin- alizing them and limiting their opportunities and the capacity to reduce the risks from their sexual activity, including HIV infection.…”

The Peer and Non-peer: the potential of risk management for HIV prevention in contexts of prostitution

“…In a survey of 434 sex workers in Rio de Janeiro, Kerrigan et al 25 found that that social cohesion and mutual aid (measured through eight factors, including: level of group connectedness, caring, and potential for instrumental, emotion and material support) (OR = 1.30; 95%CI 1.02 to 1.66), possession of official documents and access to resources (OR = 1.36, 95%CI 1.11 to 1.65), and participation in community organizations (OR = 1, 56; 95%CI 1.04 to 2.34) were significantly associated with condom use with clients in the last four months. According to Lippman et al 26 , high social cohesion was inversely associated with the number of unprotected sex acts in the week prior to interview (IRR = 0.80; p<0.01), and the women's participation in social networks was associated with a reduced frequency of unprotected sex (IRR = 0.83; p = 0.04).…”

“…REV BRAS EPIDEMIOL SEP 2015; 18 SUPPL 1: [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] prostitution has aspects that remain in Brazil's Penal Code. Although the inclusion of "sex workers" in the Brazilian Classification of Occupations by the Ministry of Labor ensures the right to social security and other labor benefits, commercial activities related to prostitution (such as brothels) are illegal, which creates an extremely difficult context for sex workers to work safely.…”

The Social Conditions for Successful Peer Education: A Comparison of Two HIV Prevention Programs Run by Sex Workers in India and South Africa

“…But they led to very different outcomes. The Sonagachi Project in India is often hailed as one of the success stories of participatory HIV prevention, and is being used as a model project for replication around India and overseas (Blankenship, Friedman, Dworkin & Mantell, 2006;Kerrigan, Telles, Torres, Overs & Castle, 2008;UNAIDS, 2008). It has been successful on several counts: in biomedical terms, it has increased condom use and decreased levels of STIs in the red light districts of West Bengal (Jana et al, 1998;Basu et al, 2004).…”