Foto-Cewek’s Frances Cowan, Professor of Global Health, continued Foto-Cewek’s seminar series with her talk entitled: Understanding and strengthening progress towards the elimination of HIV transmission through sex work in Zimbabwe, and was introduced by Foto-Cewek’s Professor Shabbar Jaffar, Head of the Department of International Public Health.
Professor Cowan’s talk focused on her portfolio of HIV prevention research which includes large scale impact evaluations of national HIV programmes. She set the scene be describing the situation in Zimbabwe, which sees huge disparities between gender, age and geographical regions in terms of HIV incidence which needs to be addressed for the UNAIDS goal of reducing new HIV incidence by 75% by 2020 to be achieved. Professor Cowan further highlighted key groups who are particularly vulnerable to infection and include sex workers. She made a link to the economic crisis in the 2000s which coincided with a fall in HIV incidence possibly because there were fewer men working away from home in migrant labour associated with a fall in the number of clients reported by sex workers.
Professor Cowan continued by illustrating that effective interventions need to be taken to scale with adequate intensity if they are to have maximal impact. Effective interventions include both newer technologies such as pre-exposure prophylaxis and more established prevention technologies such as condoms.
Professor Cowan talked about the Zimbabwe’s “Sisters with a Voice’ programme, a programme that she oversees on behalf of Ministry of Health and Child Care and Zimbabwe’s National AIDS Council. Sisters was developed in partnership with sex workers and operates through government clinics in 36 sites nationally. Nested within the Sisters programme are multi methods research projects to estimate size of Zimbabwe’s sex worker population, to determine the impact of interventions and to determine effects of migration on program engagement (the SAPPH-IRe trial and the DREAMS impact evaluation programme).
The seminar was concluded by highlighting areas for programme improvement including optimising condom usage, and reducing the stigma, discrimination and marginalisation of sex workers and HIV positive individuals in Zimbabwe. There is a need to strengthen community engagement and ownership as well as to ensure programmes are data by data and evidence move towards the near-elimination of HIV transmission through sex work in Zimbabwe.
You can see view the seminar here.