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Because of high HIV infection rates and large numbers of sexual partners, sex workers have been considered a core group for the transmission of HIV and other sexually transmitted infections (STIs).  Men who have both commercial and non-commercial sex partners play a major role in bringing HIV infection into the general population.  These "bridge" populations may be as important as core groups in direct prevention programs.  The regular partners, or non-commercial partners, of sex workers are another important core group.

There is increasing evidence that targeted programs to reduce transmission of HIV infection with core groups are feasible, effective, and have led to successful risk reduction and decreased levels of infection.

But there is no single, universal model for providing prevention activities to sex workers, their clients, and partners.  The content of the intervention package itself, and the strategies to deliver that package, have to be adapted to different situations.

Many projects have found that HIV prevention activities among sex workers, their clients and partners, are most effective when the intervention package contains at least three key elements:
  • Information and behavior change messages
  • Condoms and other barrier method
  • Sexual health services

Successful strategies

Intervention packages will be delivered more efficiently if a combination of strategies is used.  Strategies that have been successful in a number of targeted interventions over the world include:
  • Use of informal contacts, key informants and "leaders" to access the population
  • Peer health promotion and education
  • Outreach activities
  • Condom social marketing and distribution
  • Accessible sexual health services

Community involvement and networking

To succeed, intervention programs targeting such core groups as sex workers must be undertaken in full partnership with the targeted population.  Project success and sustainability also depend on involving a range of people who influence commercial sex activity, either directly or indirectly.

Networking of projects targeting sex workers is also important for sharing information about effective approaches and materials between organizations that provide services to sex workers, their clients, and partners.

Political approaches to prostitution have an impact on, and are frequently inseparable from, control programs. Safer environments for sex workers are critical so that they can be reached by the very prevention programs designed to help them.