CFAR Awards

Michele Decker, SCD, MPH

Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health

Developing and Piloting A Gender-Based Violence Intervention Module to Reduce HIV Risk among FSWs

Michele Decker, SCD, MPH - Image

Rapidly accumulating evidence demonstrates significant gender-based violence against female sex workers (FSWs) with profound HIV-related consequences including risk behavior and compromised treatment outcomes.  Globally, the programmatic HIV prevention and intervention infrastructure for FSWs relies on peer outreach workers for education and risk reduction; this system has yet to integrate violence prevention and intervention.  Doing so holds the potential to promote safety for this vulnerable population, and reduce the HIV risk that is underpinned by violence and related trauma.  To begin to fill this void, our goal is to develop and pilot test (n=30 FSWs) a violence intervention module that leverages peer outreach workers and their ongoing relationships with FSWs for seamless integration into existing HIV prevention efforts.   Using a trauma-informed, harm reduction framework, the module will train peer outreach workers to explicitly integrate discussion of violence with HIV risk, e.g., violence-related barriers to condom use, create a safe space to disclose abuse and obtain support, and build skills in safety strategies to reduce danger.  Goals will be achieved through a community-based participatory process of intervention development and refinement with key stakeholders including service providers and FSWs in the local Baltimore, MD area, with whom the investigative team has established a strong working relationship.  Resulting products, specifically the intervention itself and pilot data indicative of its feasibility, will support a subsequent R01 application to test this intervention on a larger scale, and evaluate its capacity to reduce violence and HIV risk among the key population of FSWs.