CSW Pilot Campaign Cuts STI Infection

TASHKENT, Uzbekistan, September 2, 2005 — Initial results of a PSI pilot campaign to encourage Tashkent commercial sex workers (CSWs) to seek testing and treatment for sexually transmitted infections (STIs) has shown an encouraging decrease in new STIs among those exposed to the program.

People with STIs are more likely to contract HIV, and those already HIV-positive are more likely to pass the virus on to sex partners. An informal survey conducted among 300 CSWs in Tashkent in 2004 showed that most respondents either ignore the STI or prefer to self-treat it rather than deal with costly tests in the often hostile environment of a clinic, leading to ineffective or nonexistent treatment and chronic infection.

Responding to research that revealed 79% of Tashkent's CSWs were infected with STIs, PSI/Central Asia launched the Get Healthy with Favorite! campaign as part of the USAID-funded Central Asian Program on AIDS Control and Intervention Targeting Youth and High-Risk Groups (CAPACITY). It combines the social marketing of Favorite condoms with outreach work and a referral system to encourage vulnerable groups to seek testing and treatment.

In this pilot, CSWs are encouraged to purchase high-quality, low-cost Favorite condoms and to seek STI testing. CSWs who bring in 10 empty boxes of Favorite condoms get free testing, consultation and, in the case of certain STIs, treatment at a private clinic in a high risk neighborhood of Tashkent. PSI staff and outreach workers have trained the clinic to create a friendly and open atmosphere for service provision to sex workers. The clinic was so enthusiastic about the program that its director renamed the clinic "Favorite."

In order to get the free testing and treatment, CSWs participating in the program are required to pass through a small number of fun, educational sessions where they learn about HIV/AIDS and STI prevention, correct and consistent condom use, the risks of injecting drugs (heroin injecting is common among commercial sex workers in Central Asia) and other important health topics. Each CSW is required to invite two other CSWs to the educational sessions in order to promote the program to a larger proportion of sex workers in the neighborhood. A total of 60 CSWs have participated in these educational sessions.

Twenty CSWs received STI treatment during the eight-week-long Get Healthy with Favorite! pilot. They were found to have the following STIs: eight cases of Trichinosis, 11 cases of Chlamydia, six cases of Bacterial Vaginosis, three cases of Gonorrhea and three cases of Herpes. A one-month follow-up medical examination conducted among 16 patients who were able to be contacted revealed that only one of them had a new STI infection. These results indicate that this simple and inexpensive intervention is effectively promoting the correct and consistent use of condoms in a way that is reducing the spread of STIs among sex workers.

PSI is now directly targeting the Get Healthy with Favorite! program to clients of CSWs by encouraging sex workers to invite their clients to participate in educational sessions conducted at places convenient and comfortable for them. The program is helping to reduce STI prevalence in a way that will help break the chain of STI transmission, including HIV, from sex workers to their clients and their partners and, more broadly, to the general population.

— Artur Niyazov, Indira Akhmedova and Rob Gray, PSI/Central Asia

• Archives