The program will begin with a community assessment comprising surveys of sex workers and their clients, as well as a detailed ethnographic assessment involving key informant discussions and observation. This needs assessment exercise will take approximately 6 months across all the sites involved.
Next the bars, and streets associated with commercial sex will be mapped, and sex workers' social organization, work patterns, sexual behavior, condom use, STD history, and health services will be examined. This mapping exercise will take approximately two months across all sites involved.
A total number of 2 Drop-In Centers will be opened in addition to existing ones in strategic locations based on the mapping exercise. Peer outreach will carried out 5 days a week from these Drop-In Centers.
Approximately 90 informal leaders among the sex workers will be recruited and trained as peer educators; this will involve training in STI and HIV information, educational and counseling techniques, condom promotion, and community mobilization. Peer educators will then be divided into different geographic zones where they will hold weekly community meetings in their social networks. Training of peer educators will be conducted across regional areas and will take approximately 8 weeks.
Peer educators and outreach workers will also be given supplies of condoms and lubricants to distribute at meetings, and at bars, selected workplaces, and health facilities, and free STI treatment cards for their own use and for distribution to other sex workers. Program implementation will take place over the remainder of the 2 years of the commitment.
- Needs assessment of sex workers and their clients: Needs assessment conducted across the 9 sites participating in this commitment.
- Number of peer educators trained: 90 peer educators trained.
- Peer outreach to sex workers and their clients with condom and lubricants distribution: 15 000 sex workers have accurate information and awareness of HIV and STI prevention and practice safer sex.
In Malaysia, sex work is prohibited by state and federal laws. Due to these legal issues and inadequate funding, comprehensive HIV prevention programs for sex workers are scarce. Although epidemiological data on the prevalence of HIV are inadequate, recent data from a centre providing anonymous HIV counseling and testing shows a HIV prevalence of 30% amongst female and transgender street based sex workers in Kuala Lumpur. This commitment seeks to increase access and coverage to HIV and STI prevention and care to sex workers and their clients through peer education, outreach and drop-in centres.
The Malaysian AIDS Council will partner with 12 organizations across Malaysia to scale up and expand these HIV prevention services to sex workers through enhanced training and empowerment of sex workers. As sex work is illegal in Malaysia, MAC will also engage with relevant stakeholders to advocate for policies that would enable the implementation of these programs.
In addition, the stigma that sex workers face can make it hard for them to access traditional health, legal, and social services in the country. In order to address that, more Sex Worker and Transgender Drop-In Centers need to be opened to provide these services. Without access to these services, sex workers may face a higher risk of HIV infection, and be more likely to pass on HIV if they do become infected.
The Malaysian AIDS Council seeks grants and technical assistance (including conducting needs assessment, training, monitoring, and evaluation) in order for this Commitment to be able to be implemented.