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HIV/AIDS infection is a serious threat to the health and welfare of India. HIV/AIDS and sexually transmitted infections (STI) are primarily propagated through heterosexual intercourse in India. Sex workers having multiple partners are considered to be conduits of virus transmission. Hence interventions targeting sex workers form a significant part of India's effort to curb the HIV/AIDS pandemic within its borders. The Sonagachi Project is a HIV/AIDS intervention program in India that targets sex workers. The initiative is being undertaken in a red light district of Calcutta, India. The district, which houses more than 50,000 sex workers, is the largest of its kind in South and South-East Asia. The project is spearheaded by the sex workers themselves, who act as peer outreach workers, and there are no external organizations involved. Statistics from UNAIDS show a significant drop in HIV/AIDS prevalence rate and significant increase in condom usage in Sonagachi after the project was implemented. The project achieved results like unionization of the sex workers, and formation of micro-credit societies and vocational training centers. The different facets of the Sonagachi Project were examined in the current dissertation. The articulation of trafficking and sex work in the formulation of global HIV/AIDS policy documents was assessed to understand the relationship between trafficking and sex work. The Sonagachi Project's stance on redefining sex work, legalization of sex work and rejection of rehabilitation propositions was explored. Environmental and structural barriers to health were analyzed and the impact of the contextualization of sexual health behavior on HIV/AIDS intervention initiatives studied by examining the case of the Sonagachi Project. The application of community mobilization as a strategic intervention method in HIV/AIDS harm reduction and awareness was explored by assessing the strategies of the Sonagachi Project. Finally the participatory framing of health discourse and practice in the Sonagachi Project was analyzed. For my dissertation I performed in-depth interviews of 37 sex workers and 5 project workers in Sonagachi. I reviewed policy documents of global aid organizations and project documentation from the Sonagachi Project such as research papers, internal project reports and unpublished manuscripts produced by the sex workers' union, and results of surveys performed by the sex workers' union and non-governmental organizations. The implications of the dissertation findings will extend beyond the red light district of Calcutta and provide a useful paradigm of sustainable intervention among historically marginalized populations. / Mass Media and Communication

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Residential childcare has had an image which, at the very least, is not a positive one. It has been blamed for weakening family links and leading to poor educational and health outcomes for children (Biehal et al. 1995; Mendes and Moslehuddin 2004; Stein 2002). However, children and young people enter residential care institutions for a variety of reasons, and by examining the experiences of children and young people in Bangladesh, we can see that residential childcare has the potential to offer a positive option for many disadvantaged children and young people. UNICEF estimates that there are more than 49,000 children in residential care in Bangladesh (UNICEF 2008), but this figure fails to include thousands of children who live in madrasahs. There is neither a uniform childcare policy nor formal aftercare support provision in Bangladesh; instead, the government, Non-Governmental Organisations (NGOs) and madrasahs all have their own approaches and methods and there has been no research conducted on young people in and after care. The aim of this study was to explore the experiences of residential care from the perspectives of a group of young people who had lived in residential childcare institutions in Bangladesh with a view to making improvements in residential childcare in the future. Qualitative methods were employed for data collection, using in-depth semi-structured interviews with 33 young people (aged between 12 and 26) who had left the care system and observation of the four institutions where they had lived: one run by an NGO, two run by the government and one madrasah run by the religious community. All of the fieldwork was conducted and transcribed in Bangla. The findings of this study show that young people had mixed feelings about their lives in care, preparation for leaving care, and aftercare support; moreover, their experiences were diverse. Overall, most said that they had benefited from being in care and the institution had had a largely positive impact on their lives. However, the experience for those who had been evicted was much less favourable; these young people suffered a range of hardships after leaving care. The findings also show that there was a connection between the in-care experience and the success of a young person in the outside world. The type of institution, its culture, systems and practices, the amount of care received and socio-cultural-religious influences all played a part. The research further indicated that although some young people developed a measure of resilience to face the problems of their everyday lives, they were not fully able to overcome them due to societal discrimination. Those who did best where those who had developed positive attachments with at least one trusted adult, who acted as a mentor and strengthened their commitment and self-motivation. The findings demonstrate that aftercare support varied from institution to institution, but overall, was informal in nature. The study concludes by setting out implications for building better residential childcare policy and practice in Bangladesh. It identifies a number of avenues for further research, suggesting that lessons for the minority world may be learned from this study, namely the notion that the whole community should take responsibility for its children; and attention should be paid to faith and religious beliefs in children’s upbringing. The study has also demonstrated that improving financial resources may not necessarily lead to better outcomes from children and young people. Instead, building relationships with adults, peer groups, parents, and community offer the best chance for good outcomes.

INTRODUÇÃO: A aids e hepatites virais constituem problemas de saúde pública mundial. As prevalências são mais elevadas em populações de maior vulnerabilidade, como as profissionais do sexo. OBJETIVO: analisar a prevalência da infecção pelo HIV e HBsAg em profissionais do sexo feminino e aspectos sociais, comportamentais, estado vacinal contra hepatite B e resposta vacinal. METODOLOGIA: trata-se de um estudo transversal que contemplou uma parte descritiva e outra interventiva, realizado no período de março de 2012 a março de 2013. Foram entrevistadas 402 mulheres profissionais do sexo, que foram incluídas pela técnica de \"bola de neve\" (snowballtechnique). Amostras de sangue foram coletadas para detecção de anti-HIV e marcadores sorológicos da hepatite B (HBsAg e anti-HBs). As mulheres com resultados sorológicos reagentes foram encaminhadas para um Serviço de Referência. Após levantamento do estado vacinal contra Hepatite B, as mulheres foram vacinadas conforme aceitação e necessidade; a resposta vacinal foi investigada 30 dias após cada dose de vacina recebida. Todos os preceitos éticos foram respeitados. Os dados foram avaliados por meio de estatística descritiva. Para verificar a associação entre as variáveis qualitativas, os dados foram submetidos ao Teste Exato de Fisher e valores de p menores que 0,05 foram considerados significativos. RESULTADOS: a idade das participantes variou de 18 e 64 anos; a maioria das mulheres, ou seja, 255 (63,4%) referiram não ter um companheiro; evidenciou-se baixo nível de instrução, sendo que 270 (67,16%) possuíam de 3 a 6 anos de estudos e 47 (11,7%) eram analfabetas. Para buscar auxílio à saúde, essas mulheres afirmaram que utilizavam o Serviço de Urgência como a principal estratégia de acesso. Foram identificados nove (2,3%) casos de HIV e dois (0,5%) casos de infecção pelo HBsAg, entre as 380 (94,5%) que concordaram em realizar a coleta. Do total de 315 mulheres aptas para receber a vacina, 91 completaram as três doses de vacina; deste modo, foi possível avaliar resposta vacinal em 57 mulheres; desse total, 56 mulheres apresentaram títulos protetores maiores que 10 UI/ml. O principal motivo para a não adesão as três doses de vacina contra Hepatite B foi o não comparecimento na data agendada. CONCLUSÃO: profissionais do sexo têm maior vulnerabilidade ao HIV quando comparado com a prevalência de 0,33% em gestantes de Teresina (PI) no ano de 2011. Quanto à prevalência ao vírus da Hepatite B, foi considerada baixa para essa infecção. Portanto, o reconhecimento das áreas de prostituição do município de atuação, e uma assistência integral por meio de programas de saúde poderão ser impactantes na redução e controle de doenças verticais; controle de doenças crônicas; reduzir complicações e refletir na melhoria da qualidade de vida da população / BACKGROUND: AIDS and viral hepatitis constitute public health problems worldwide. Prevalence rates are higher in populations most vulnerable, such as sex workers. OBJECTIVE: To assess the prevalence of HIV infection and HBsAg in female professional and social, behavioral and hepatitis B vaccination status and vaccine response METHODOLOGY: This is a cross-sectional study which involved a descriptive and other interventional conducted from March 2012 to March 2013. We interviewed 402 female sex workers that were included by the technique of \"snowball\" (Snowball technique). Blood samples were collected for detection of anti - HIV and hepatitis B serological markers (HBsAg and anti - HBs). Women with serological reagents were routed to a Service Reference. After surveying the hepatitis B vaccination status, women were vaccinated according to acceptance and necessity; vaccine response was investigated 30 days after each dose of vaccine received. All ethical guidelines were adhered to. The data were analyzed by descriptive statistics. To verify the association between qualitative variables, the data were subjected to Fisher\'s exact test and p values less than 0.05 were considered significant. RESULTS: The age of participants ranged from 18 to 64 years; most women, 255 (63.4 %) reported not having a partner, showed a low level of education of which 270 (67.16 %) had 3 to 6 years of study and 47 (11.7%) were illiterate. To seek assistance to health, these women reported using up the ER as the primary access strategy. Identified nine (2.3%) cases of HIV and two (0.5 %) cases of HBsAg infection among the 380 (94.5 %) participants. A total of 91 315 women completed the three doses of vaccine and vaccine response could be assessed in 57 women, of this total, 56 women had protective titers higher than 10 IU / ml. The main reason for non-adherence ace three doses of hepatitis B vaccine was not appearing on the scheduled date.CONCLUSION: sex workers have increased vulnerability to HIV when compared with the prevalence of 0.33 % among pregnant women in Teresina - PI in 2011. As the prevalence of hepatitis B virus, was considered low for this infection, though most share sharp objects such as pliers and blades. The recognition of areas of prostitution in the city of operation, and comprehensive care through health programs, may be impacting on the reduction and vertical disease control, control of chronic diseases, reduce complications and reflect on improving the quality of life

Previous research on female street sex workers (FSSWs) has primarily concentrated on the stigmatisation of women's involvement in the sex industry particularly with reference to the spread of HIV/AIDS. The response of the criminal justice system to the regulation of the illegal aspects of women's engagement in street sex work has also been criticised. However, the impact of street sex work on the health and wellbeing of these women requires further research. The aim of this study was to explore the perceptions and needs of female street sex workers in relation to their own health and wellbeing. The study used a qualitative mixed methods approach that included analysis of three sets of data: visual data, secondary data and primary data. There were 10 FSSWs recruited for the primary data sample. The epistemological position underpinning this study is social constructivism and a feminist paradigm has informed the conduct of the research process and data analysis. The theoretical application of Bourdieu's framework of habitus, capital and field has provided the lens through which to explore the socially constructed experiences of FSSWs health and wellbeing. Findings from this study revealed that FSSWs experienced poor physical, mental and social health and wellbeing. They faced limited life choices and often felt discriminated against by the agencies and institutions that should have offered support. The women spoke of their personal histories especially traumatic life events in childhood consisting of sexual abuse, neglect, loss, rejection as well as intimate partner violence in adult life. The loss of their children to social services, housing difficulties and addiction to alcohol and crack cocaine were also significant in contributing to social exclusion and their multiple positions of vulnerability. This study contributes to the body of work on women's health and wellbeing. In particular, it adds to our understanding of the lived experiences of women involved in street sex work. A key public health priority should be the development of policies and systems to provide quality services to support the health, safety and wellbeing of FSSWs.

Within the last ten years HIV rates in Central Asia have more than quadrupled amongst the general population. Labor migrants from the region who are working in Russia are considered at high risk of HIV infection due to risky sexual practices. Similar behavior has been documented among labor migrants in sub Saharan Africa. By reviewing medical data and literature written by international health professionals in both regions, I analyze the chain of sexual contact of labor migrants within female partners that contribute to the spread of HIV from Russia to the general population within Central Asia. I use Tajikistan as a case study. The findings of this study recommend that existing behavior modification strategies need to recognize existing gender structures when addressing at risk populations. They must also emphasize collaboration with community religious leaders and civil society organizations to promote effective and appropriate HIV/AIDS education efforts in order to curb the growing prevalence rates among male labor migrants in Central Asia. / text

INTRODUÇÃO: A aids e hepatites virais constituem problemas de saúde pública mundial. As prevalências são mais elevadas em populações de maior vulnerabilidade, como as profissionais do sexo. OBJETIVO: analisar a prevalência da infecção pelo HIV e HBsAg em profissionais do sexo feminino e aspectos sociais, comportamentais, estado vacinal contra hepatite B e resposta vacinal. METODOLOGIA: trata-se de um estudo transversal que contemplou uma parte descritiva e outra interventiva, realizado no período de março de 2012 a março de 2013. Foram entrevistadas 402 mulheres profissionais do sexo, que foram incluídas pela técnica de \"bola de neve\" (snowballtechnique). Amostras de sangue foram coletadas para detecção de anti-HIV e marcadores sorológicos da hepatite B (HBsAg e anti-HBs). As mulheres com resultados sorológicos reagentes foram encaminhadas para um Serviço de Referência. Após levantamento do estado vacinal contra Hepatite B, as mulheres foram vacinadas conforme aceitação e necessidade; a resposta vacinal foi investigada 30 dias após cada dose de vacina recebida. Todos os preceitos éticos foram respeitados. Os dados foram avaliados por meio de estatística descritiva. Para verificar a associação entre as variáveis qualitativas, os dados foram submetidos ao Teste Exato de Fisher e valores de p menores que 0,05 foram considerados significativos. RESULTADOS: a idade das participantes variou de 18 e 64 anos; a maioria das mulheres, ou seja, 255 (63,4%) referiram não ter um companheiro; evidenciou-se baixo nível de instrução, sendo que 270 (67,16%) possuíam de 3 a 6 anos de estudos e 47 (11,7%) eram analfabetas. Para buscar auxílio à saúde, essas mulheres afirmaram que utilizavam o Serviço de Urgência como a principal estratégia de acesso. Foram identificados nove (2,3%) casos de HIV e dois (0,5%) casos de infecção pelo HBsAg, entre as 380 (94,5%) que concordaram em realizar a coleta. Do total de 315 mulheres aptas para receber a vacina, 91 completaram as três doses de vacina; deste modo, foi possível avaliar resposta vacinal em 57 mulheres; desse total, 56 mulheres apresentaram títulos protetores maiores que 10 UI/ml. O principal motivo para a não adesão as três doses de vacina contra Hepatite B foi o não comparecimento na data agendada. CONCLUSÃO: profissionais do sexo têm maior vulnerabilidade ao HIV quando comparado com a prevalência de 0,33% em gestantes de Teresina (PI) no ano de 2011. Quanto à prevalência ao vírus da Hepatite B, foi considerada baixa para essa infecção. Portanto, o reconhecimento das áreas de prostituição do município de atuação, e uma assistência integral por meio de programas de saúde poderão ser impactantes na redução e controle de doenças verticais; controle de doenças crônicas; reduzir complicações e refletir na melhoria da qualidade de vida da população / BACKGROUND: AIDS and viral hepatitis constitute public health problems worldwide. Prevalence rates are higher in populations most vulnerable, such as sex workers. OBJECTIVE: To assess the prevalence of HIV infection and HBsAg in female professional and social, behavioral and hepatitis B vaccination status and vaccine response METHODOLOGY: This is a cross-sectional study which involved a descriptive and other interventional conducted from March 2012 to March 2013. We interviewed 402 female sex workers that were included by the technique of \"snowball\" (Snowball technique). Blood samples were collected for detection of anti - HIV and hepatitis B serological markers (HBsAg and anti - HBs). Women with serological reagents were routed to a Service Reference. After surveying the hepatitis B vaccination status, women were vaccinated according to acceptance and necessity; vaccine response was investigated 30 days after each dose of vaccine received. All ethical guidelines were adhered to. The data were analyzed by descriptive statistics. To verify the association between qualitative variables, the data were subjected to Fisher\'s exact test and p values less than 0.05 were considered significant. RESULTS: The age of participants ranged from 18 to 64 years; most women, 255 (63.4 %) reported not having a partner, showed a low level of education of which 270 (67.16 %) had 3 to 6 years of study and 47 (11.7%) were illiterate. To seek assistance to health, these women reported using up the ER as the primary access strategy. Identified nine (2.3%) cases of HIV and two (0.5 %) cases of HBsAg infection among the 380 (94.5 %) participants. A total of 91 315 women completed the three doses of vaccine and vaccine response could be assessed in 57 women, of this total, 56 women had protective titers higher than 10 IU / ml. The main reason for non-adherence ace three doses of hepatitis B vaccine was not appearing on the scheduled date.CONCLUSION: sex workers have increased vulnerability to HIV when compared with the prevalence of 0.33 % among pregnant women in Teresina - PI in 2011. As the prevalence of hepatitis B virus, was considered low for this infection, though most share sharp objects such as pliers and blades. The recognition of areas of prostitution in the city of operation, and comprehensive care through health programs, may be impacting on the reduction and vertical disease control, control of chronic diseases, reduce complications and reflect on improving the quality of life

Background: Syphilis infection has recently resurfaced as a significant public health problem. Although there has been a tremendous amount of research on the epidemiology of syphilis, there has been limited work done to synthesize the extensive body of research and systematically estimate patterns of disease within high-risk groups in the Americas. The purpose of this systematic review and meta-analysis is to (1) summarize recent patterns of syphilis infection in North and South America among four high-risk groups (MSM, transgender women, sex workers, and incarcerated individuals) from 1980 to 2016, (2) identify and differentiate regional geographic epidemiologic characteristics, and (3) compare the epidemics of the economically developed countries of North America from the developing countries and public health systems of Latin America and the Caribbean. Methods/design: Primary studies reporting syphilis prevalence and/or incidence in at least one of the four high-risk groups will be identified from Medline/PubMed, Embase, Lilacs, SciELO, The Cochrane Library, Web of Science, Scopus, ProQuest, CINAHL, Clase, and Periódica, as well as "gray" literature sources (conference abstracts, country reports, etc.). Studies published from 1980 through 2016 will be included. Data will be extracted from studies meeting inclusion and exclusion criteria and a random effects meta-analysis of prevalence and incidence estimates will be conducted. Heterogeneity, risk of bias, and publication bias will be assessed. Pooled prevalence and incidence estimates will be calculated for comparisons based on geographic region, risk factors, and time period. Discussion: Our systematic review and meta-analysis aims to contribute to an improved understanding of global epidemiologic patterns of syphilis infection in most-at-risk populations. Through systematic classification of the existing literature, and comparison of disease patterns across regional, temporal and socio-behavioral differences, we hope to improve public health surveillance and improve efforts to control the spread of disease across the Americas. Systematic review registration: PROSPERO CRD42016047306.

In 2007, one current and two former sex workers, Amy Lebovitch, Terri-Jean Bedford and Valerie Scott launched a charter challenge, Bedford v Canada, arguing that the prostitution provisions criminalizing bawdy houses (section 210), living on the avails (section 212 (1)(j)) and communicating for the purposes of prostitution (section 213.1 (c)) violated their section 7 rights under the Charter of Rights and Freedoms. Six years later, the Supreme Court of Canada ruled unanimously to strike down all three challenged laws, leaving a one-year period to construct a new regime on prostitution. On December 6, 2014, the Protection of Communities and Exploited Persons Act (PCEPA) came into effect, criminalizing, for the first time, prostitution in Canada and introducing a law that replicates many of the provisions of the previous regime. This thesis uses semi-structured interviews and qualitative analysis to examine the experiences of nine street-based sex workers in Ottawa, paying particular attention to experiences after the introduction of the new law. Drawing on the work of Mead & Blumer’s symbolic interactionism theory and Goffman’s concept of stigma the thesis examines how embedded stereotypes in legislation ‘play out’ in the lives of sex workers. I argue that the interactions of sex workers in Ottawa are conditioned by stereotypical assumptions which in turn lead to their broader discrimination and marginalization. This study concludes by finding that the first objective of PCEPA, to protect those who sell their own sexual services, has not been met; instead, PCEPA has resulted in street-based sex workers in Ottawa assuming more risk, and in turn, facing more danger while on the job.