S14.1 Transitions around sex work and their significance in STI/HIV epidemics

Abstract

In many regions of the world, the importance of formal sex work in driving HIV epidemics is well-established and it is recognised that female sex workers (FSWs) experience a disproportionately high risk of HIV globally. Sex work and sex work networks are complex and continuously evolving and therefore FSW research needs to address this changing nature of HIV risk as well as the contribution of other important factors to the overall HIV epidemic, such as macro-structural determinants, sub-population-level social and sexual networks, individual behaviours and host and viral biological factors. Further, early HIV and STI risk has been particularly identified as being an important area of programmatic and research focus. In an effort to understand the complexity and risk trajectory associated with sex work, the “Transitions” study examines the HIV risk and vulnerability among young women and FSWs over the life course from the structural, network, behavioural and biological perspectives. Transitions also aims to dissect the contribution and interaction of factors within these different areas (structural, network, behavioural and biological) that drive HIV risk and transmission at an individual- and population-level. Disentangling the role of these contributing factors in HIV risk could shed light on the optimal mix of HIV interventions that is proportionate to the relative influence of these drivers. This presentation will introduce a framework that demonstrates how Transitions brings together the various perspectives in its work in the different epidemiological contexts of Ukraine and Kenya. For the latter, mapping results from Ukraine and Kenya will be reviewed. This presentation will also show how such a framework is used to guide research and inquiry in order to generate meaningful and concrete findings that could have implications on HIV prevention and control programming.