PROJECT STAFF

Miss Nicole Gilkes (Project Coordinator)

Miss Mikala Hope-Franklyn (Project Administrator)

AIM:

To acquire baseline information on the Sex Worker (SW) population in order to facilitate the design of appropriate interventions to reduce the incidence and prevalence of Sexually Transmitted Infections and HIV among the SW population in Barbados.

OBJECTIVES:

1.      To establish a broad understanding of the perceptions of SWs about their practice as it relates to STI/HIV.

2.      To assess factors which facilitate the spread of STI/HIV among SWs.

3.      To identify the vulnerabilities of the SW population (their clients and partners) in the specific areas investigated during the mapping exercise.

4.      To identify the type of STI and HIV intervention strategies applicable to the current situation of SWs in Barbados.

5.      To understand the barriers that may mitigate against the implementation of STI/HIV intervention strategies in the sex trade in Barbados.

Internationally, SWs are generally viewed as a more vulnerable group in terms of the transmission of sexually transmitted infections (STIs) and HIV, due to their high rate of sexual partner turnover and reported high rates of STI  (UNAIDS,2002).  In the Caribbean, the limited numbers of studies investigating seroprevalence rates in SWs have indicated that the SW group exhibits a higher HIV seroprevalence rate than the general population (Carter, 1997; Douglas, 1997).

Previous governmental intiatives

In October 1997, the Ministry of Health in collaboration with CAREC-GTZ (Caribbean Epidemiology Centre-German Technical Co-operation) and the AIDS Society of Barbados initiated the club-based female SWs project ‘STI/HIV Prevention among Club-based Female Sex Workers’. This intervention project focused specifically on the conducting of educational sessions (on the use of HIV preventative measures) with female club-based SWs in the established red-light city district. Subsequently, the project was curtailed due to a series of immigration raids in the city district coinciding with the project workers’ entry to this area which disrupted the relationship between the project workers, bar/club owners and the SWs.  As a result no published material was produced.

Previous studies

A subsequent cross sectional study, conducted during the months August to September 1999, investigated the feasibility of conducting a peer education project among beach boys (Marshall, 1999). This study consisted of survey (structured) interviews with beach boys and persons who were considered ‘tourism stakeholders’. Several issues including the sexual behaviour of beach boys (condom use, type of relationships formed between beach boys and their clients), opinions on STI/HIV testing and opinions on the mode of implementation and efficacy of a peer education programme among the beach boy target group were examined.  The study findings revealed that beach boys were interested in acquiring additional information on STI and HIV transmission and they were also aware of the risks associated with unprotected sexual intercourse with clients (paying partners)  and or tourists but did not consider  unprotected sexual intercourse with non-paying partners (Barbadian and non-Barbadian). 

 Project Phases

 The project consists of two phases, the preparatory phase and the intervention phase:

1.      PREPARATORY PHASE

The preparatory phase involves the building of alliances with key stakeholders, the mapping of SW activities, the conduct of a baseline study and the preparation of a project proposal outlining the requisite intervention strategies.

-      The Mapping Phase (May- October 2003)

This phase of the project involved the mapping of the SW activities in five areas of Barbados. The mapping phase was designed to provide the requisite background/preliminary information about the scope and context of sex work in Barbados, including the areas of SW activity, approximate numbers of SWs at each location and the identification of potential key informants.

-   The Baseline Study (March 2004 - March 2006)

The baseline study (in the five areas investigated in the mapping phase) consists of focus group sessions &/in-depth interviews and a baseline survey of the target population (female SWs, male SWs and MSM SWs). The focus group sessions and in-depth interviews commenced in March 2004 and were expected to be completed by September 2004, however insufficient funding resulted in a temporary halt to the further conduct of interviews and focus group sessions.  The scheduled date for the completion of data gathering is December 2006.   The baseline survey was conducted concurrently with further in-depth interviews.   

The focus groups and in-depth interviews did not commence immediately upon the completion of the mapping phase, due to a number of considerations.  Firstly, the project staff sought to acquire the services of a dedicated consultant to facilitate both the in-depth interviews and focus groups.  Additionally, there was the acute necessity to acquire funding to contract the before-mentioned consultant, who could conduct the in-depth interviews and focus groups.

Baseline Survey

The ultimate goal of the STI/HIV Prevention among Male and Female Sex Workers in Barbados project is to contribute to a reduction in the incidence and prevalence of STIs and HIV/AIDS among sex workers, their clients and partners, in Barbados. The baseline survey was conceptualized as the second phase of the project baseline study which would incorporate qualitative and quantitative methodologies in order to provide a broad understanding of the context of the commercial sex trade in Barbados and provide specific information which could be used to provide a basis for the design of appropriate intervention strategies for the target (SW) population. 

The baseline survey was conducted from primarily from January to March, then August to December 2006 in the five areas investigated during the project preparatory phase.  

1.      The vulnerabilities of the sex worker population, their clients and partners; in the specific areas investigated during the mapping exercise.

2.      The intervention strategies required to address the identified vulnerabilities of the SW population, their clients and partners, to STI/HIV transmission.    

The baseline survey utilized a snowball sampling method for the recruitment of study subjects. The survey instruments incorporated information gathered from the Family Health International guidelines on the preparation of Behavioural Surveillance Surveys (FHI, 2000). Two survey instruments have been administered to the SW population (the first instrument for female SWs and the second instrument for all categories of male SWs including MSM SWs.  

The baseline survey is designed to provide specific quantitative information which would compliment the qualitative data collected during the focus groups and in-depth interviews.

RESEARCH AND OUTREACH

Whilst baseline study phase of the project is dedicated to the acquisition of information and data gathering, significant linkages have been forged with the SW population and Key Informants in the areas specified.  Additionally in an effort to make initial contact with SWs, specifically those street, based in the areas documented during the mapping phase, the project staff was able to provide demonstrations in keeping the Ministry’s social marketing of the female condom, during 2004.  This in additional to the provision of information and demonstrations of the male condom and the disclosure of the primary activities of the project, the project staff was able to establish first contact with street based SWs.  To date the Project staff continues to conduct demonstrations for SWs and prospective clients and bar patrons, along with the distribution of condoms to SWs.

Along with the above activities the project has provided both pre and post VCT sessions to SWs and Key informant desirous of this service.

Project Workshop

The final workshop was conceptualised in order to disseminate the preliminary findings of its Baseline Study (both qualitative and quantitative components). The workshops was hosted over   November 9^th & 10^th 2006 at the Accra Beach Hotel and Resort.   Its aim was primarily to ensure the dissemination of preliminary findings, but the Project’s Staff, in conjunction with stakeholders and project funding partners, saw the necessity of using this workshop as a forum to benefit fledgling and already established SW Projects throughout the Caribbean. 

Additionally ideas were posited from the various attendees of how to make regional sex work project more successful, but attaining and exchanging technical support from within and outside of the fraternity, whilst sharing ideas to attain funding from appropriate donor agencies.

The workshop also therefore, facilitated the following:

-     The dissemination of the preliminary project findings to the project stakeholders and participants

-    The initial conceptualization of the proposed interventions

-      Provided an opportunity for funding agencies and those requiring funding to meet and through information sharing reach mutually beneficial positions with regard to investment in Projects of this nature.

-      Regional networking and the provision of a forum for further collaboration among SW project staff from a number of territories within the confines of Latin America and the Caribbean. This is particularly necessitated due to the transient nature of sex work and its implications, specifically, with the advent of the CSME.