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Consensus statement from the consultation on HIV epidemiology and prostitution, Geneva, 3-6 July 1989.
[Unpublished] 1989. 5 p. (WHO/GPA/INF/89.11)Interventions capable of reducing the risk of HIV infection among prostitutes and their clients were the topics of a special consultation in July 1989 convened by WHO's Global Program on AIDS and Sexually Transmitted Disease (STD) Program. Since mathematical modelling of HIV transmission indicated that population groups with the highest rate of sexual partner change contribute disproportionately to the transmission of HIV, interventions targeted at prostitutes have the potential to greatly reduce the impact of the AIDS epidemic. Greater use of condoms among prostitutes, increased awareness of the STD-AIDS link, the substitution of alternative methods of sexual stimulation for penetrative sex, better utilization of health care services by prostitutes and their clients for the diagnosis and treatment of STDs, and increased support of safer sex practices from managers of prostitute businesses all have proved to be effective interventions. However, more widespread application of these interventions has been hindered by the following: an unwillingness on the part of clients and managers to support sex workers' demand for the routine use of condoms; an inability to reach less visible prostitutes; a lack of political and financial support for such programs; the presence among prostitutes of other high- risk behaviors such as intravenous drug use; and legal restrictions that instill a belief in prostitutes that they cannot control their lives. Most effective have been interventions that empower prostitutes to determine their working conditions and enhance their ability to negotiate with clients and managers for adequate health care and safer sex practices.