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Essential elements of a community empowerment approach to HIV prevention among female sex workers engaged in project Shikamana in Iringa, Tanzania.

Authors
  • Leddy, Anna M1
  • Mantsios, Andrea2
  • Davis, Wendy3
  • Muraleetharan, Ohvia4
  • Shembilu, Catherine5
  • Mwampashi, Ard5
  • Beckham, S Wilson2
  • Galai, Noya6
  • Likindikoki, Samuel5
  • Mbwambo, Jessie5
  • Kerrigan, Deanna2, 3
  • 1 Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
  • 2 Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
  • 3 Department of Sociology, American University, Washington, DC, USA.
  • 4 Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA.
  • 5 Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania. , (Tanzania)
  • 6 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Type
Published Article
Journal
Culture, health & sexuality
Publication Date
Apr 01, 2020
Volume
22
Issue
sup1
Pages
111–126
Identifiers
DOI: 10.1080/13691058.2019.1659999
PMID: 31496423
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Globally, female sex workers bear a disproportionate burden of HIV, with those in sub-Saharan Africa being among the most affected. Community empowerment approaches have proven successful at preventing HIV among this population. These approaches facilitate a process whereby sex workers take collective ownership over programmes to address the barriers they face in accessing their health and human rights. Limited applications of such approaches have been documented in Africa. We describe the community empowerment process among female sex workers in Iringa, Tanzania, in the context of a randomised controlled trial of a community empowerment-based model of combination HIV prevention. We conducted 24 in-depth interviews with participants from the intervention community and 12 key informant interviews with HIV care providers, police, venue managers, community advisory board members and research staff. Content analysis was employed, and salient themes were extracted. Findings reveal that the community empowerment process was facilitated by the meaningful engagement of sex workers in programme development, encouraging sex worker ownership over the programme, providing opportunities for solidarity and capacity building, and forming partnerships with key stakeholders. Through this process, sex workers mobilised their collective agency to access their health and human rights including HIV prevention, care and treatment.

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