Abstract

PIP: Sex workers are learning about acquired immunodeficiency syndrome (AIDS) prevention through peer education. In early 1986, no clinical AIDS case had been diagnosed in Ghana. 1 of 98 prostitutes living near Accra was infected with the Human Immunodeficiency Virus (HIV). By the end of 1986, 72 Ghanians were infected with the virus, 63 of them women. This 1st pilot project's strategy was to test the feasibility of an attempt to stop the spread of HIV infection in Accra by increasing spermicide and condom use among sex workers. Discussions were organized with small groups of female prostitutes. An informal communication network already existed among them. Most had heard of AIDS, but did not know how it was transmitted. They thought that they were at risk, but did not know what to do about it. The discussions led to making 6 women leaders or peer educators. After being trained, these peer educators talked with 72 other prostitutes and gave them spermicides and condoms free of charge. In June, 1987, 72 prostitutes took a knowledge, attitudes, and practice (KAP) survey on AIDS/HIV and sex practices. In January, 1988, only 45 of the original 72 completed the follow-up interview. Before the project, 1 in 3 women (among the original 72) understood that they could get the disease from an apparently healthy man; at the end, 9 out of 10 understood this. Reported use of spermicides and/or condoms with customers increased greatly. Only 9 of 72 (13%) reported regular use of spermicides or condoms in the beginning. 6 months later, 89% said they used spermicides and/or condoms regularly. There are some problems with the results. More women wanted to get into the project as word spread about the purpose of the condoms. Another 144 prostitutes were enrolled in a supplementary program. This group bought the condoms at wholesale prices. Peer education has been brought into many HIV intervention programs in Africa, India, Mexico, and the Dominican Republic Republic. 11 female prostitutes were paid to work with 125 of their peers in Cameroon. Peer education has been incorporated into the family planning program of the Mexican Federation of Private Family Planning Associations. This involves 1500 commercial sex workers.