DGH Lecture Series: Gabrielle O'Malley

Addressing the “Demand” Side of Sex Work: The Need for Male-focused Interventions to Reduce the Spread of HIV/AIDS in Botswana Gabrielle O’Malley, PhD International Training and Education Center for HIV, University of Washington

Context ,[object Object],[object Object]

Exploratory/Diagnostic Study ,[object Object],[object Object],[object Object],[object Object],[object Object]

Botswana: Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Source: UNAIDS/WHO, 2008; available from: http://www.who.int/globalatlas/predefinedReports/EFS2008/full/EFS2008_BW.pdf Estimated Adult* HIV Prevalence, 1990–2007 * “Adult”= ages 15–49

Study Sites in Botswana ,[object Object],Ghanzi Letlhakane Francistown Gaborone Selebi-Phikwe

CSW Intervention Focus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Targets : Women involved in commercial sex work or at risk for CSW

Investigation Map HIV risk in sex work FSW Customers NGOs (peer HIV education; economic opportunity [skills training]) Traditional healers Formal medical community

Study Methods (1) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Study Methods (2) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Study Limitations ,[object Object],[object Object],[object Object]

Qualitative Research ,[object Object],[object Object],[object Object]

Areas of Inquiry for Women ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Areas of Inquiry for Men ,[object Object],[object Object],[object Object]

Demographics of Women N=30 ,[object Object],[object Object],[object Object],[object Object],[object Object]

Years as FSW Years as a FSW Std. dev = 2.98 Mean = 4.0 N = 30.00

Customers per Day Average number of customers per day Std. dev = 2.10 Mean = 3.9 N = 30.00

FSWs’ Perspective - Economic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],Awareness of HIV Risk

[object Object],[object Object],Cost (Risk)-Benefit Analysis

Cost (Risk)-Benefit Analysis ,[object Object]

Comparative Risk Analysis ,[object Object]

Limited Alternative Opportunities ,[object Object]

Survival Sex and Beyond ,[object Object]

Motivations of FSW ,[object Object],[object Object],[object Object],[object Object]

Masculinity and Sex ,[object Object]

Masculinity and Sex ,[object Object],[object Object]

Disempowered Men ,[object Object],[object Object]

Lack of Male Self-efficacy ,[object Object]

Blame and Responsibility ,[object Object],[object Object]

Men’s Perspectives ,[object Object],[object Object],[object Object],[object Object],[object Object]

Gender Construction as Backdrop ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Risky Sexual Behavior

Implication for Program Interventions ,[object Object]

Support for Male Focused or “Gender” Interventions ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object]

DGH Lecture Series: Gabrielle O'Malley

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DGH Lecture Series: Gabrielle O'Malley