Reducing the Impact of HIV/AIDS among Female Sex Workers in Benue State Nigeria
Concern Women International Development Initiative implemented a six month long project from April 2014 to November 2014 on improving the health of Female Sex Workers in Markudi Benue State by reducing the incidence of HIV/AIDS infection among female sex workers (FSW) and their clients. The Minimum Prevention Package Intervention (MPPI) and Priority Location for AIDS Control Efforts PLACE was used as a strategy to reach the target population.
This is a single intervention that prevents the transmission of HIV with combination of effective behavioral, bio-medical and structural interventions.
Through the approach, Concern Women International Development Initiative ensured that FSW had access to a core package of interventions for HIV prevention and reached FSW with activities from at least three of the predetermined intervention categories. Target populations and hotspots were identified using PLACE.
1. To increase access to a comprehensive package of HIV sexual prevention activities at sufficient intensity and quality among female sex workers in Markdui Benue State by the end of 2014.
2. To improve a continuum of community and facility based prevention, care and treatment for FSW in Markudi Benue State by the end of 2014.
3. To enhance the knowledge of STI among female sex workers in Markudi Benue State by the end of 2014.
HOW THE OBJECTIVES WERE ACHIEVED
Concern Women adopted the combination of behavioral, biomedical and structural interventions in reducing the burden of HIV/AIDS among female sex workers. On 25th to 26th of April 2014, a total number of 45 FSW were trained as peer educators at Lobi Hotel Markudi Benue State. The peers were provided with information focusing on risk reduction, partner reduction, and correct and consistent use of condom with key message ‘Unprotected sex increases your risk to HIV infection, use condoms with water-based lubricants correctly and consistently! Each peer educator conducted three sessions per three months with their peers, and the following topics were discussed: Goal setting, decision making, self Esteem, values, Negotiation and refusal skills, knowledge of HIV/AIDS, HIV/AIDS transmission and prevention, Sexual transmitted infections with pictures of different types, symptoms including the importance of regular screening, and prevention, personal sexual risk.
This project seeks to adopt a holistic approach to addressing the health needs of female sex workers. The success stories that would emanate from this project will be documented and disseminated as best practices for possible replication in other states. The data gathered from the project using monitoring and information system (MIS) adds value to other work currently doing by Concern Women, other Non Governmental organisation, federal ministry of health and National agency for control of Aids (NACA). This is because the data will be reported into the District Health Information System (DHIS), an established, web-based reporting system designed to capture facility-based information. The data generated will aid future research on FSW.
Increased access to a comprehensive package of HIV sexual prevention activities at sufficient intensity and quality among female sex workers in Markdui Benue State by the end of 2014 improved continuum of community and facility based prevention, care and treatment for FSW in Markudi Benue State by the end of 2014 enhanced the knowledge of STI among female sex workers in the region.
During the training, provision was made for 40 FSW but in attendance were 45 FSW, thereby accumulating extra costs for Concern Women. However, all were accommodated at the expense of Concern Women. Also during the STI training we budgeted for 20 FSW, but a total of 30 FSW were in attendance.
The FSW demanded that condoms and lubricants should be made available on weekly basis in an open area inside the hotel. This message was passed to UNFPA Benue and Society for Family Health who has accepted the responsibility.
The industrial actions embarked upon by the Nigerian medical association in July which lasted till August 2014 delayed the carrying out of the training workshop for the 10 private providers earlier engaged. However, the participants were informed about the postponement of the training and therefore, the training was shifted to September 2014
During group discussion it was discovered that most of the FSW did not know their HIV status.
An important lesson learned from the project is that understanding the local context is crucial to the success of a project. This was observed during the training of private providers on FSW-friendly services. I also learned the power of advocacy which could be seen when we paid a visit to the local police to inform them about the project. We told them about the aim and objectives of the initiative, since their support will go a long way to maintain the stability of our efforts. We needed to ensure that the target population would not be harassed and intimidated by the police.