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News From The Journal Of Clinical Investigation, July 6, 2009

HEPATOLOGY: Immune cells linked to severe infant liver disease
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Sex Workers In Pakistan Give Recommendations On HIV Prevention To Health Officials

Although the recorded HIV prevalence in Pakistan is relatively low, health officials are concerned that a concentrated epidemic of the virus among injection drug users could carry over to commercial sex workers and other high risk groups in the country, IRIN/PlusNews reports. To address the issue, the National AIDS Control Program and the United Nations Population Fund recently held a meeting, called the National Consultation on HIV and Sex Work, in an effort to improve HIV prevention efforts targeted at sex workers by consulting with workers in the field.Sex workers at the meeting made various recommendations, including HIV testing, referrals and increased efforts to decrease stigma. The Ministry of Health reports that from 2006 to 2007, female sex workers were at a high risk of HIV in 12 cities across Pakistan. A survey of 4,639 female sex workers found that less than 25% reported condom use; 10% had a partner that had used injection drugs during the past six months; and that illiterate sex workers were less likely to use condoms than those with a higher level of education. A female sex worker at the meeting said, "It is very hard for us to convince [partners] to put on a condom, but I feel that a female condom would put us in a position where we can protect ourselves against HIV and sexually transmitted infections." She added that female condoms are not widely available. Legalizing sex work would make it easier for sex workers to protect their rights, another female sex worker at the conference said. She added that often, outreach workers face barriers from police forces. Daniel Baker, UNFPA"s country representative for Pakistan, said that sex workers should have greater involvement in creating and implementing HIV programs. He added, "The female sex workers have to be in there as managers, workers and leaders to benefit in the long run." Safdar Kamal Pasha with UNFPA agreed that the recommendations from sex workers are critical points to address in future programming. "The female sex workers agreed that there should be vocational training and the means for alternative work opportunities for those who want to move out of sex work, as well as those who are past their prime and do not find sustainability in sex work," Pasha said (IRIN/PlusNews, 5/14).