Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Page 140

5 Clinical and Support Services Figure 5.3 Roles and responsibilities for STI services • Develop guidelines/standards • Train state-level coordinators • Regular technical support • Monitor outcomes • Operations research • Train NGO and GO clinic staff • Supervise based on standard and quality monitoring tools • Provide STI services • Coordinate with outreach • Report on indicators • Promote STI services • Track sex workers for regular service use • Use services • Give feedback on services • Become involved in service delivery NATIONAL PROGRAMME MANAGER/ COORDINATOR STATE-/DISTRICT-LEVEL COORDINATORS NGO/GO CLINIC STAFF COMMUNITY AND STAFF OUTREACH WORKERS SEX WORKERS B. Implementing and managing STI services Set up STI services Establish STI services that are accessible and acceptable for sex workers based on available resources and capacity. STI services should be respectful and non-judgemental, and should address sex workers’ particular needs. In establishing clinical services, consider the factors listed in Table 5.1 to balance access with cost. Establish STI health care-seeking behaviour as a community norm It is essential that sex workers be aware of the symptoms of STIs and be encouraged to seek care promptly, and to seek regular STI screening. Linking STI services to outreach and community services helps achieve this. Coordination with sex worker-led outreach is essential to promote STI services and support clinic follow-up. At the same time, provision of STI services reinforces condom promotion and education by community outreach workers. Clinic staff should develop strong communication with community outreach workers. Improving communication and referrals increases the overall prevention effect. 118