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Peer education is increasingly being used to combat the spread of HIV and AIDS. However, results are inconsistent. This study systematically compares the context and implementation of two peer educational approaches among sex workers in India and South Africa, which had contrasting outcomes, to identify factors leading to success or failure. The Indian intervention's success was enabled by: a stable, supportive social, material and political context; and an ethos of community development which committed resources to sex worker empowerment, ownership and involvement. …
Pasa la Voz (spread the word) is a methodology used to prevent HIV using respondent-driven sampling to reach hard to access women. An organization in Ciudad Juarez (Programa Companeros) initiated a one-to-one approach to reaching at-risk and hard to reach women in the area using promotoras (outreach workers) from September 2005 to January 2006. The implementation of Pasa la Voz came on its heels and had success in increasing the number of women agreeing to get tested for HIV (11.9% to 49.9%) and decreasing testing time from 22.70 hours to 3.68 hours per test.
The importance of designing and implementing successful targeted interventions for sex workers as part of HIV prevention and control cannot be over-emphasised. In almost every country, sex workers comprise a focal point of the epidemic. They are the victims of discrimination, often violently intense, trafficking, legal persecution and societal ambivalence as well as one of the first occupational groups to become heavily infected. The infection passes from sex workers back to their clients and into the general population of women, men and children. One of the clearest public health lessons emerging from the HIV pandemic is that protecting the human rights of sex workers is an important means of prevention.