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XIth International Conference on Aids - Vancouver, BC, Canada, July 1996

HIV Prevention directed at Sex-workers :
	the Blue Booklet
An Example of a European Twinning Project within MCAP AIDS
[picture]

Yves LAMBERT, Christine BINSFELD, Paul ALONSO, Nicole DOME and anonymous street sex-workers.
Antigone (a welfare and prevention program on AIDS and prostitution), ARS, Nancy, France

BACKGROUND	As participants of the ‘Healthy Cities’ WHO Project Mutli-City Action Plan on AIDS, the cities of Rotterdam (Netherlands) and Nancy (France) have shared expertise and experiences on HIV prevention, support and care for several years. This collaboration has led both the Municipal Service of Health for Rotterdam Area and Antigone (Nancy) to build up a ‘twinning project’ based on the transfer of knowledge and skills from Rotterdam to Nancy.
OBJECTIVE	To prevent AIDS, STDs and hepatitis among male and female street sex-workers in Nancy by : improving knowledge of HIV/AIDS, STDs and hepatitis improving awareness of behaviour patterns that put street sex-workers at higher risk helping them to negociate safer behaviour patterns with their clients.
METHODS	Contacts with street sex-workers in the areas of the city where they are active (especially at night) Workshop composed by the team of Antigone and male and female prostitutes some of whom were HIV positive and/or drug injectors. The aims of this workshop were : mutual training sessions analysis of existing educational materials, from different European countries, whether specifically directed at sex-workers or not needs assessment writing up a booklet called the ‘Blue Booklet’ (in French : 'petit livret bleu').
RESULTS	Observed about the sex-workers participating in the workshop : they gave up behaviour patterns that formerly put them at higher risk they are now able to educate their peers they notably increased their self-esteem. The team that led the project has learned that : needless to try to educate sex-workers directly about HIV/AIDS or STDs : they do not agree easily to talk about such topics ; at first, they expressed no interest because they think their knowledge is sufficient the framework used to write up the ‘Blue Booklet’ showed a better effectiveness by developing the following issues : safety at work à well-being à health à AIDS + STDs + hepatitis awareness à safer behaviour patterns messages are better perceived and accepted if they are broadcasted by peers as concrete methods, profitable tricks and usable advice. Over the last 20 months, most of the male and female street sex-workers contacted have declared that : they took a great interest in reading the ‘Blue Booklet’, which is described as a useful ‘practical book’. Some keep it constantly on them or in their car. Some requested a new booklet because they gave theirs away they have changed some specific behaviour patterns they no longer accept some sexual demands. the main ‘resistance’ in adopting safer sex behaviour patterns has been found in the sub-group of drug addicts.
CONCLUSION	Sharing expertise and experiences within a European city network like the WHO Project ‘MCAP AIDS’ helps to avoid reinventing the wheel ! Knowledge and skills are transferable from one European city to another with good results despite their apparent differences (size, cultural background, legal organisation, health and welfare system, etc.) A community based project, paying greater attention to the views of the targeted group, gives the best guarantee of a successful outcome.

With the support of :

the Commission of the European Communities, the French Ministry of Welfare (DDASS 54), the Agency of Social Security in Nancy (CPAM), the Municipal Service of Health Rotterdam Area, the city of Nancy.

For further information, please contact :
Antigone BP 818 F-54011 Nancy cedex Tel. : +33 383 30 84 78 — Fax : +33 383 36 86 11

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