Sex workers

toolkit material

As discussed in the mapping report, two options exist for conducting behavioural surveillance related to sex work.

  1. To identify sex workers’ clients and assess their sexual behaviour with sex workers. In this case, the indicators proposed are those included in the core set of indicators (3 indicators).
  2. To adapt these indicators to sex workers (2 indicators).
  3. To add one indicator on access to services.

Title and definition: The proportion of men who have paid for sex in the past 12 months  

 

Purpose and rationale  The potential impact of sex work on STI or HIV transmission in the population should be informed by some estimate of the size of the population of clients. This will also indicate the scale of preventive interventions for those who pay for sex.
Measurement frequency

Every 4-5 years in the general population (depends on the frequency of data collection in the general population)

 

Title and definition: The proportion of men who have paid for sex in the past 12 months who report using a condom last time they paid for sex

 

Purpose and rationale  The use of condoms in commercial sexual encounters is a key preventive measure for both HIV and STI prevention. If programmes are effectively reaching sex workers and clients then this proportion will increase. It is a key indicator
Measurement frequency

Every 4-5 years in the general population (depends on the frequency of data collection in the general population)

 

Title and definition: The proportion of men who have paid for sex in the past 12 months who have had an HIV test (in the last 12 months)

 

Purpose and rationale  Men who pay for sex may be at-risk of HIV, and should be encouraged to take responsibility for their sexual health and ensure that they are not putting others at-risk
Measurement frequency

Every 4-5 years in the general population (depends on the frequency of data collection in the general population)

 

Title and definition: The proportion of sex workers who used a condom last time they were paid for sex

 

Purpose and rationale  There is strong evidence that high levels of condom use can be achieved in commercial sex through relatively simple interventions, and that, if achieved, this can lead to a decline in STI and HIV in sex workers. In some settings this has also been associated with decline in risk amongst the wider population. This is therefore a key indicator of the impact of preventive interventions.
Measurement frequency

Every 2 years

Additional sources of information  UNGASS indicator No 18. See the Guidelines on contruction of core indicators from the United Nations General Assembly Special Session on HIV/AIDS   

 

 

Title and definition: The proportion of sex workers who have had an HIV test in the last 12 months

 

Purpose and rationale  Sex workers may be at-risk of HIV, and should be encouraged to take responsibility for their sexual health and to ensure that they are not putting others at-risk. This indicator serves as a measure of their individual awareness and of  access to health care and preventive services.
Measurement frequency

Every 2 years

Additional sources of information  UNGASS indicator No 8. See the Guidelines on contruction of core indicators from the United Nations General Assembly Special Session on HIV/AIDS   

 

Title and definition: The proportion of sex workers who have access to preventive services

 

Purpose and rationale  There is strong evidence that simple preventive interventions for sex work that include health promotion, condom distribution and voluntary access to STD/HIV service can reduce HIV and STI risk. This indicator measures how well programmes are investing in, and delivering, these basic services.
Measurement frequency

Every 2 years

Additional sources of information  Similar to UNGASS indicator No 9 Percentage of most-at-risk populations reached with HIV prevention programmes. See the Guidelines on contruction of core indicators from the United Nations General Assembly Special Session on HIV/AIDS