{"id":5954,"date":"2021-12-23T16:48:11","date_gmt":"2021-12-23T16:48:11","guid":{"rendered":"https:\/\/kmtraining.org\/hiv-and-contraceptive-service-integration-for-female-sex-workers\/"},"modified":"2026-04-28T12:50:14","modified_gmt":"2026-04-28T12:50:14","slug":"hiv-and-contraceptive-service-integration-for-female-sex-workers","status":"publish","type":"post","link":"https:\/\/kmtraining.org\/fr\/hiv-and-contraceptive-service-integration-for-female-sex-workers\/","title":{"rendered":"HIV and Contraceptive Service Integration for Female Sex Workers"},"content":{"rendered":"
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Key populations, including female sex workers, face barriers to health care access that include stigma, criminalization, and gender-based violence. In many cases, these barriers can be mitigated by peer educators, who bring valuable insight and may engender trust with clients.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n

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Female sex workers are among the priority populations that are the focus of the Meeting Targets and Maintaining Epidemic Control (EpiC) project, funded by the United States Agency for International Development (USAID) and the U.S. President\u2019s Emergency Plan for AIDS Relief (PEPFAR). Because HIV and family planning services are critical and, too often, unmet needs for female sex workers, USAID and PEPFAR endorse integrated delivery<\/a>.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n

<\/span><\/div>[rs_blockquote cite=”Agness John, an FHI 360 senior technical officer for HIV programs in Tanzania”]The barriers that sex workers face regarding access to health services can be mitigated by peer educators because of the valuable perspective they bring.[\/rs_blockquote]
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The stigma associated with sex work is a primary reason that peer educators and their lived experiences are irreplaceable<\/a>. Peers educators often know the locations of sex workers, and they will not discriminate or pass judgment in the way that some providers may. Given these factors, they have a unique opportunity to counsel and meet the needs of their peers who are trying to prevent sexually transmitted infections (STIs) and prevent or plan pregnancy. Training developed specifically for peer educators positions them to have the greatest impact when counseling clients.<\/p>\n

Data show that many female sex workers who would like to prevent pregnancy are not using a contraceptive method. Those in low- and middle-income countries in Africa have higher rates of unmet family planning need<\/a> than the general population. Among surveyed sex workers, 30% in Madagascar had an unmet need for family planning, and 70% in Cote d\u2019Ivoire had experienced an unplanned pregnancy.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n

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PEPFAR\u2019s Country Operational Plans<\/a> call for integration of family planning and HIV services, including the provision of pre-exposure prophylaxis (PrEP), and note that a one-stop shop is particularly important for reaching key population members with services they need. Likewise, technical guidance<\/a> from the Global Fund to Fight AIDS, Tuberculosis and Malaria advocates for focused efforts to integrate high-quality HIV and family planning services and to address discrimination.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n

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To strengthen integration efforts, FHI 360 published The Peer Educator Tool for Informing Female Sex Workers about Contraceptive Options<\/a><\/em>. Developed through the EpiC and Linkages across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES) projects with funding from USAID, EpiC teams are beginning to use the toolkit (Figure 1).<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div>

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Peer educator activity. Click here for an accessible version (slide 6 of 40).<\/a><\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div>\n\t

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Making Options Clear<\/h3>\n

The toolkit, designed for peer educators who work with HIV programs, has a user guide, peer educator tool, and session plan. It provides tangible processes and resources for peer educators to present basic information on a range of contraceptive options, encourage clients to determine their needs, and explain how to obtain each method. The properties of contraceptive options are described, and a skills checklist gives peer educators a way to assess their practices for empathetically and respectfully interacting with clients.<\/p>\n

When used properly, the tool supports positive interaction between the peer educator and female sex worker by facilitating eye contact, providing easy-to-understand and relevant information, and enabling confidential discussions.<\/p>\n\n\t\t<\/div>\n\t<\/div>\n

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The Contraceptive Services for Female Sex Workers<\/em><\/a>\u2014Training Module for Clinicians is designed to orient clinicians to the special needs and concerns of female sex workers seeking contraceptive services. It includes a facilitator manual and slide presentation. The toolkit focuses on reasons they may prefer certain methods and how to provide nonjudgmental, informed-choice counseling. The learning objectives include:<\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div>

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Training module for clinicians. Click here for an accessible version (slide 32 of 35).<\/a><\/p>\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div>\n\t

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