Condoms, both male and female

Condoms, both male and female, are the single most effective available technology to
reduce the sexual transmission of HIV and other sexually transmitted infections43.
Condoms must be readily available for sex workers and their clients, either free or at low
cost, and conform to global quality standards. Condom access must be accompanied by
programmes that actively promote condom use, including the availability of water-based
lubricants and HIV education for sex workers, clients, owners of sex work establishments
and controllers. Programmes to reduce HIV transmission associated with sex work
should maximize successful negotiation of condom use, including through supporting
their use in formal sex work establishments, and through ensuring consistent supplies of
high-quality condoms in health settings, pharmacies and informal distribution points.
Drug and alcohol use, violence, exploitative management practices by brothel owners
and controllers, and harassment by law enforcement officers44 reduces the ability of sex
workers to negotiate condom use; governments and service providers should address
such factors to maximize the impact of condom programming focused on sex work.
Successful prevention approaches also need to address condom use and negotiation
between sex workers and their regular partners.45
Linking and integrating services
Integrating HIV and sexual and reproductive health programmes can significantly reduce
HIV infection and improve the quality of life of people living with HIV46. Health care
workers, including those in primary health care settings and youth friendly services,
should be aware of and responsive to the specific health needs of sex workers and
clients, including regular testing and counselling; access to maternal and infant health
services; dual protection47; family planning, and mental health issues48. Service linkages
and integration should encompass sexual and reproductive health, including sexually
transmitted infection management and treatment services; tuberculosis programmes;
programmes to prevent mother-to-child HIV transmission; hepatitis prevention and
treatment services; psychosocial and mental health support, and referral to appropriate
services for women and children who are victims of trafficking and commercial sexual
exploitation49. Service hours and delivery strategies should be as flexible to address the
local sex work context.