Effective programs that avert new HIV infections among sex workers and their partners, and hence the general population, are critical components of national HIV-prevention strategies. Prevention efforts have frequently relied on interventions that reach members of these vulnerable groups as individuals, such as condom promotion and STI management. Now, many researchers and program implementers are increasingly turning to “environmental-structural” interventions that address the physical, social, and political contexts in which individual behavior takes place. A recent Horizons study conducted jointly with two Dominican NGOs—Centro de Orientación e Investigación Integral and Centro de Promoción e Solidaridad Humana—and the National Program for the Control of STDs and AIDS assessed the impact of two environmental-structural models in reducing HIV-related risk among female sex workers in the Dominican Republic and compared their cost-effectiveness. As detailed in this brief, the models, built on years of experience gained from sex worker peer education programs, drew from the strengths of both community solidarity and government policy initiatives and engaged community members in both program and policy development.
Kerrigan, Deanna, Luis Moreno, Bayardo Gomez, Hector Jerez, Ellen Weiss, Johannes van Dam, Eva Roca, Clare Barrington, and Michael D. Sweat. 2004. "Community approaches and government policy reduce HIV risk in the Dominican Republic," Horizons Research Summary. Washington, DC: Population Council.