“Fearless”: Improving Sexual & Reproductive Health of Female Sex Workers

Targeted Interventions allow female sex workers to access services in a more supportive and less stigmatizing environment as compared to government hospitals. (Photo by Peter Caton for India HIV/AIDS Alliance)

Targeted Interventions allow female sex workers to access services in a more supportive and less stigmatizing environment as compared to government hospitals. (Photo by Peter Caton for India HIV/AIDS Alliance)

In India, as elsewhere, female sex workers (FSW) have considerable unmet sexual & reproductive health (SRH) needs due to their occupation and social marginalization. They shy away from accessing SRH services due to stigma and discrimination, negative attitudes of healthcare providers, and fear of law enforcement agencies, clients and people opposed to sex work.

Under the country’s National AIDS Control Program (NACP), targeted interventions (TIs) for FSWs are implemented to provide access to HIV prevention services. TIs allow FSWs to access services in a more supportive and less stigmatizing environment as compared to government hospitals. Unfortunately, TIs do not include SRH services in spite of the immediate relevance of these services.

Evidence, both global and national, has shown that linking HIV and SRH services provide a valuable impetus to encourage uptake of prevention, treatment, and care and support services, especially by people living with HIV (PLHIV) and key populations, including FSWs. With this approach in mind, India HIV/AIDS Alliance with support from MAC AIDS Fund has initiated a pilot programme Abhaya – meaning ‘fearless’ in Hindi – for FSWs in Andhra Pradesh and Gujarat.

Within existing TIs for FSWs, Abhaya expands access to complementary SRH services. The project enables FSWs and their partners to reach to a broader range of services like SRH information, counselling, referral and linkages to facilities providing relevant services. Along with this, the intervention also builds the capacity of existing healthcare providers and other relevant stakeholders to ensure a responsive attitude towards FSWs. Abhaya will also engage in advocacy with the government to identify opportunities to adapt and scale-up these expanded services in a stigma-free environment as a part of the national strategy.

Abhaya gives a significant role to FSWs and their partners in the implementation of the programme at all stages to increase ownership and the potential for sustainability of the initiative. Over the pilot year, the programme will reach 3,000 FSWs, helping them to better identify their SRH needs and access quality services thus empowering them to protect their overall health and wellbeing.

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The author of this blog, Kumkum Pal, is Programme Officer: HIV & SRHR at India HIV/AIDS Alliance.

Supported by the MAC AIDS Fund, Abhaya expands access to sexual and reproductive health (SRH) services as part of HIV prevention interventions for female sex workers (FSWs) in Andhra Pradesh and Gujarat. The programme will complement the existing targeted intervention (TI) programme under the country’s National AIDS Control Program (NACP) by providing key SRH services and linkages and increase the desirability and value of the TIs for FSWs. Alliance India is implementing the programme with support from Sakhi Jyot in Gujarat and Prema Sangam Mahila Mandali in Andhra Pradesh.

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