Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Page 59

2 Addressing Violence against Sex Workers

Monitoring and evaluation of violence prevention and response efforts are important because:
• Data on violence faced by sex workers provide a basis for planning and designing appropriate
strategies.
• Including indicators on violence faced by sex workers in the routine monitoring framework allows
programmes to monitor whether there are any unintended consequences of sex work interventions,
e.g. “backlash” violence.
• Evidence on violence faced by sex workers is a powerful tool for advocacy efforts to change laws
and policies related to sex work and create an enabling environment for promoting the rights of
sex workers.
Evaluation of violence prevention and response strategies with sex workers is necessary before
most of the options presented in Section 2.2 are scaled up. Gathering accurate information about
violence requires that sex workers have trust and be comfortable disclosing their experiences of
violence. Care should be taken that collection of data or documentation of incidents of violence
does not further endanger the safety of sex workers or stigmatize them. Building trust depends
on the ethical and safety measures included in data collection, and the skills of data collectors in
sensitively asking relevant questions. WHO ethical and safety guidelines for researching violence
against women are recommended as a standard to be followed in gathering data on violence against
sex workers (see Section 2.4). Sex workers must be equal partners in the design, implementation
and dissemination of results from any data collection activity related to violence and other human
rights violations against them.
There are currently no validated and internationally agreed-upon population-based impact indicators or
programmatic indicators that are specific to violence faced by sex workers. Indicators for monitoring
and evaluating interventions that address violence against sex workers would therefore need to be
developed or adapted and validated based on existing indicators on violence prevention and response
with the general population of women.
In some settings, such as India, integrated bio-behavioural surveys on STIs and HIV implemented
with key populations, including sex workers, have included indicators on violence faced by sex
workers, e.g:
• Percentage of sex workers surveyed who were physically beaten or forced to have sexual
intercourse by an individual against their will in the past one year.
However, these surveys do not capture the range of physical and sexual violence experienced by
sex workers as defined in Box 2.1. Data collected based on such terms as “beaten or raped” may
underreport the violence experienced by sex workers.It may therefore be useful to conduct additional
research, including qualitative research, to better understand the context, dynamics and factors that
fuel violence against sex workers.
In India, where the Avahan AIDS Initiative included crisis response systems to address violence,
programmes have also collected data on reported incidents of violence faced by sex workers. These
indicators include:
• Number of sex workers who report incidents of physical violence
• Number of sex workers who report incidents of sexual violence
• Perpetrators of any violence reported by sex workers, by category (e.g. police, intimate partner,
client)

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