Online Program

Pilot testing of a Human Rights-Focused HIV Intervention for Sex Workers in Manila, Philippines

Sunday, November 1, 2015

Lianne Urada, PhD, MSW, LCSW, Department of Medicine, Division of Global Public Health and Center on Gender Equity and Health, University of California, San Diego, La Jolla, CA
Janie Simmons, EdD, National Development and Research Institutes, Inc., New York, NY
Betty Wong, BS, University of California, San Diego, La Jolla, CA
Laufred Hernandez, MMPM, MA, University of the Philippines, Manila, Department of Behavioral Sciences, Manila, Philippines
Nymia Pimentel Simbulan, DrPH, College of Arts & Science and College of Public Health, University of the Philippines, Manila, Manila, Philippines
Girlita Enrera, BA, Woodwater Center for Healing, Quezon City, Philippines
Anita Raj, PhD, Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
Background: This study pilot tested a human rights-focused HIV intervention for sex workers in the Philippines.

Methods: A single-session group intervention to reduce sexual risk and increase HIV testing among 86 sex workers in Manila was evaluated with pre- and posttest survey data. The 4-hour empowerment intervention, Kapihan, (5 groups; August-November, 2013), integrated HIV education and skills building with human rights education on a) sex worker rights/community mobilization, b) safety from work-related violence and police, and c) reproductive rights/ access to family planning services. Academic-community international collaborators from the Philippines and the U.S. designed the intervention. Demographic data and outcomes of HIV knowledge and risk behaviors, victimization from violence/trafficking, and human rights knowledge were collected. Pre-post outcome changes were assessed via Wilcoxon's signed ranks and Mann-Whitney tests. 

Results: Participants had a median age of 23; 69% were female; 55% had children; 22% had 3+ children; 18% had children before age 18 years; 16% used drugs (past 3 months); 66% had a history of sexual or physical violence from clients; 20% of street-based sex workers ever took an HIV test. Pre-post test scores significantly improved in knowledge related to HIV (z =-8.895, p<.001), reproductive health (z=-3.850, p<.001), human rights (z =-4.391, p<.001), ethical rights of research participants (z=-5.081, p<.001), and intentions to test for HIV (z =-4.868, p<.001).  

Conclusions: Integrating human rights education into HIV prevention approaches for sex workers may support efforts to empower them with knowledge on how to address their health and human rights concerns.

Learning Areas:

Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice
Ethics, professional and legal requirements
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Social and behavioral sciences

Learning Objectives:
Design a human rights-focused HIV intervention for sex workers. Describe a unique 4-hour empowerment intervention conducted in the Philippines. Discuss the ethical conduct of research via community-based research methods and collaboration with stakeholders and via community mobilization.

Keyword(s): Vulnerable Populations, Self-sufficiency and Empowerment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Assistant Professor at UC San Diego in the Division of Global Public Health, Department of Medicine and a core faculty member of the Center on Gender Equity and Health. I am Principal Investigator on a NIDA K01 grant (1K01DA036439-01), NIH Fogarty International award, and a Fordham Research Ethics Training Institute Fellow (R25DA031608), and a Co-investigator on a R01 NIMH Men Count intervention(PI: Raj)and Kaiser Permanente HIV Test and Treat community based study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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