4 Condom and Lubricant Programming
Box 4.5
National policies to promote condom use
• Encourage“ safe workplaces” and availability of condoms in all sex work venues.
• Revise / remove laws that penalize possession of condoms.
• End the practice of law enforcement officials using condoms as evidence of sex work.
• End practices of law enforcement officials confiscating condoms from sex workers.
• Ensure that current laws / policies incentivize owners of sex work venues to stock condoms.
• Decriminalize or de-penalize sex work in order to reduce fear among sex workers and increase condom use.
Condom distribution programmes should work in partnership with key institutions and individuals to ensure support for condom distribution and promotional activities. Key institutions include national ministries of health, local health departments, local clinic personnel and other relevant members of the health system. Key individuals(“ gatekeepers”) include managers of entertainment establishments, nightclubs, brothels, guesthouses and hotels, and others involved in the commercial sex industry. Implementing organizations should work with these individuals to ensure they understand the importance of condom programming and are supportive of it.
Condom programming should never be an isolated activity. In order to be successful, condom promotion and distribution should always be conducted as part of a broader package of health services and activities should be implemented with sex worker leadership and involvement. At the local level, condom programmes should work with sex workers to consider situations where condom use tends to be compromised( e. g. group sex, alcohol and drug use, violence) and to devise solutions that reduce the frequency of those situations or increase condom use in them. Depending upon the local context, either advocacy or programmatic solutions, or both, could address these situations.
Box 4.6
Local strategies for creating an enabling environment for condom programming
• Ensure that condoms are widely available through condom outlets or machines in locations where sex is sold, such as brothels, bars, guesthouses and hotel rooms, and in transport hubs such as train and bus stations, petrol stations, and rest stops on highways.
• Place condoms directly in hotel or guesthouse rooms rather than at lobby desks. This ensures that they are readily available when and where sex occurs and prevents their confiscation by law-enforcement officials.
• Provide proper disposal locations( i. e. garbage cans) in places where sex is sold so that condoms may be disposed of properly and not create visible trash.
• Train local police to promote and protect the human rights of sex workers and HIV / STI prevention knowledge, including the need for condom promotion and distribution.
• Provide community outreach workers with identification cards signed by local police authorities to prevent them from being harassed while they are conducting outreach work.
• Implement workplace-based programmes with clients of sex workers focused on sexual health, including the reduction of demand for unprotected paid sex.
89