Description of the problem
Female sex workers (FSW) in southern Africa bear the brunt of the HIV epidemic. In Zimbabwe HIV prevalence among FSW is 55%. They have high rates of sexually transmitted infections and face societal stigma and violence related to their work. Research evidence suggests that interventions to mobilise and empower FSW can mitigate their risks of HIV and STI incidence and violence by building social cohesion as well as strengthening engagement with services, critical if programme coverage is to be optimised and UNAIDS targets are to be reached.
Study objectives To explore the impact of microplanning and self-help groups among female sex workers on uptake of and engagement with HIV, SRH and other health services, confidence and self-efficacy, financial literacy and security and psychological resilience.
Methods The Sisters programme in Zimbabwe provides nationally scaled services for female sex workers. We piloted an intervention to build resilience and social cohesion of sex workers and strengthen their link to clinical services using self-help groups and microplanning (data guided, peer-led, risk differentiated outreach).
Results Self-help groups were feasible to run and acceptable to FSW although in some sex work hotspots took time and more intensive support to fully establish. FSW engaged in self-help groups and supported each other by arranging child care, encouraging each other to go to get clinical care, establish savings and lending schemes and in some cases to return to educational or vocational training.
Conclusion Sex workers were empowered and able to make better life decisions. Priorities for the groups changed over time and as trust increased. Self-help-groups can become autonomous of programme support over time. Microplanning allowed us to regularly reach women not previously engaged in the programme. We plan to test the cost effectiveness of this intervention in a cluster randomised trial.
Disclosure No significant relationships.
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