Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Page 80

3 Community-led Services

Setting:
• In urban areas, programmes should consult with community outreach workers to decide whether
outreach to sex workers who work on the streets should be conducted in pairs for safety.
• It may be difficult to reach sex workers who work in urban bars, brothels or lodges. Outreach to
managers and owners, to encourage them to allow community outreach workers access into the
establishments, should be undertaken in pairs, with other programme staff if necessary. Since
these sex workers often live together in groups, outreach to them in their residences may be more
productive, but only if welcomed.
• Outreach to home-based sex workers or those who choose not to self-identify as sex workers
requires a discreet approach, such as framing it as health promotion for low-income women.
Age:
• Younger sex workers may have concerns about family planning and maintaining their physical
appearance, while also wishing to maximize their client load.
• Older sex workers may be more concerned with protecting their children, providing support for
HIV-positive family members and participating in programme management.
Gender:
The needs of male, transgender and female sex workers may overlap, but also differ in some respects:
• Male sex workers may require counselling and referrals for such issues as sexual dysfunction.
• Transgender sex workers may need information on the risks associated with injecting hormones.
• Female sex workers may need support related to family planning and abortion services.
Supervising and supporting outreach
An outreach supervisor/manager has the responsibility to train, motivate and monitor the work of
five to twenty community outreach workers. The role may be filled by a community outreach worker
who has progressed into this supervisory role or by an NGO staff member until community outreach
workers are trained.
The outreach supervisor/manager observes community outreach workers in their day-to-day outreach
work, reviews their data on components of the service package (number of one-to-one contacts,
group contacts, referrals or accompanied visits, condoms distributed, etc.), and may input the data
into a computerized management information system if there is no dedicated data entry officer. The
supervisor/manager has weekly meetings with his or her group of community outreach workers,
usually at the safe space (drop-in centre), to discuss high-priority individuals and any problems the
community outreach workers may be encountering, and to provide informal training.

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