The Toolkit for targeted HIV/AIDS prevention and care in sex work settings is dedicated to

Paulo Henrique Longo (1964-2004)

who contributed with enthusiasm and commitment, knowledge and insight to its development. Paulo was a warm, engaging and deeply humane person, an effective and articulate advocate and activist, from whom there was always something new to learn. His commitment and passion in promoting HIV/AIDS issues and his tremendous contribution to the welfare of the sex worker communities surely made a difference and will always be remembered.

In many parts of the world, sex workers have been among the groups most vulnerable to and most affected by HIV since the beginning of the AIDS pandemic. After more than a decade of research and intervention in sex work settings there is a substantial body of knowledge on the behaviours that put sex workers, their clients and regular partners at risk and on the contextual factors that create vulnerability to HIV/AIDS. In addition, much has been learnt about what works to prevent HIV transmission in sex work settings, about how to provide care and support services, and to empower sex workers to improve their health and well-being. 

Some of this knowledge has been disseminated through published research and conference presentations but much knowledge and expertise has not been formally documented or exists only in unpublished reports. The purpose of this toolkit is to make both published and unpublished information more accessible to a wider audience, and so to contribute to global efforts to develop and scale up effective HIV interventions in sex work settings.

Most of the items in this toolkit focus on HIV prevention in such settings. Less information is available on treatment, care and support for sex workers living with HIV. Tools relating to these matters will be added as they become available.

Who is the toolkit for?

The toolkit is intended for use by anyone involved in HIV prevention and care initiatives in sex work settings.

Aim and content

The toolkit is intended as a resource to guide the development and implementation of effective HIV interventions in diverse sex work settings. It outlines key steps and issues and provides links to many documents, manuals, reports, and research studies containing more detailed and in-depth information. Each such resource or tool has been annotated to assist readers in deciding whether it is relevant to their particular situations.

The inclusion of any specific document in the toolkit does not necessarily indicate that its content represents the decisions or the stated policy of the World Health Organization. 

Structure

The toolkit is divided into the following sections, which provide an introduction to the sex work context and describe the basic steps for the development and implementation of interventions.

Context for HIV interventions in sex work settings

• The public health rationale
• A Strategic framework
• Key principles

Development of interventions

• Category 1: Assessment
• Category 2: Planning and design
• Category 3: Implementation
• Category 4: Management
• Category 5: Training and capacity-building
• Category 6: Monitoring and evaluation

The categories are defined as above in order to facilitate the retrieval of relevant information, although there is considerable overlapping between them.

Toolkit development process
 
Before inclusion in the toolkit, items are reviewed by a committee of experts in order to determine their quality and relevance. The committee includes representatives from sex work networks, WHO, UNAIDS and national and international NGOs.

New tools/resources will be added to the on-line collection as they are released. User feedback is welcomed in order to make improvements to the toolkit and to ensure that it continues to respond to emerging and changing needs.

Feedback or new tools, documents or resources to be considered for inclusion in the toolkit in any language should be emailed to hiv-aids@who.int or sent to:

World Health Organization
Department of HIV/AIDS
20 avenue Appia
CH-1211 Geneva 27
Switzerland

Language

The resources in this toolkit are reproduced in their original language. Most are available only in English.

Authorship

The guidance text of the toolkit was prepared by Dr. Catrin Evans, University Nottingham, and edited by Manuela Möller, Richard Steen, Monica Beg under the supervision of Isabelle de Zoysa (WHO).

A Technical Reference Group was established to assist with preparing this toolkit by commenting on drafts and resources and providing information. WHO wishes to acknowledge this group for its contribution and to thank its members:

WHO wishes to acknowledge the generous contribution of German Technical Cooperation (GTZ) to the development of this toolkit.