Gaining acceptance of the target community – a real challenge for a doctor working in sex workers project

 



Sugata Mukhopadhyay, Smarajit. Jana

Issues: Remodeling role of healthcare provider in enhancing efficacy of the Sex Workers HIV prevention program.

Description: While working in Sonagachi (a brothel consisting of 7000 FSWs) SW project in Kolkata, India as a doctor I recognized that only technical skill is not enough in getting acceptance of the community. I discovered there are four determining factors. First, the doctor must consciously challenge his/her “moral values” towards the community to remove barriers between service providers and sex workers. Secondly, s/he should be in the position of identifying multiple socioeconomic needs of the SWs directly and indirectly linked with their sexual health problems. Thirdly, the structural and livelihood issues closely associated with high risk behavior of SWs should be firmly addressed through the intervention program where doctor’s involvement makes a big difference. Finally, physicians have role to play in capacity building of the SWs, providing support in building their self esteem, confidence and facilitating strategic advocacy with an objective to protect their right ensuring safe sex practices. The very approach can help community to attain citizenship triggering positive lifestyle. Therefore, healthcare provider, more specifically has to play duel role as doctor as well as “community associate” to make changes.

Lessons learned: This very realization and strategic actions made me highly accepted and recognized by SWs and helped to run sexual health intervention program smoothly with full community participation and ownership to make significant impact on HIV prevention (since the inception of the program during ’92 till date it has succeeded in stabilizing HIV prevalence level between 3% - 5%).

Recommendations: Doctors recruited to work in SW projects must go through well designed orientation programs to augment their prompt acceptance by the community for bigger interest of the project. Such programs compulsorily include attitudinal change in addition to socio-economic and structural issues that impinges safe sex practices.

AIDS 2006 - XVI International AIDS Conference

Abstract no. WEPE0854 (selected for poster presentation)